A Modified Angled Plate for Fixation of Proximal Femoral Varus Osteotomy in Paralytic Hip Dislocation

Abstract

Objectives: Femoral osteotomy is an important step in the management of paralytic hip dysplasia. Fixation by the angled plate is demanding and carries the risk of many complications. In this study, we made certain modifications for the angled plate, and we aim to assess the results of the modified plate for fixation of proximal femoral varus osteotomy in paralytic hip dysplasia. Method: Twenty patients with paralytic hip dislocation were included in this study. The ages ranged from 5 to 15 years with an average of 9 years. There were 12 boys and 8 girls. Seventeen patients had cerebral palsy and 3 had meningocele disease. Pre-operative radiographs were done, and the migration percentage (MP), acetabular index (AI), and neck-shaft angle (NSA) were measured. All patients were treated by open reduction, pelvic osteotomy, and proximal femoral varus osteotomy. The femoral osteotomy was fixed by the modified angled plate in all cases. Results: The osteotomy sites united in all patients and the average time of union was 3 months. The acetabular index, migration percentage, and neck-shaft angle were reduced postoperatively. This reduction was statistically significant. The hips remained stable throughout the period of follow-up in all patients. No cases were complicated by nonunion or implant failure. Conclusion: The modified angled plate (canulated interlocking blade plate 90°) is a good method for the fixation of proximal femoral varus osteotomy in the management of paralytic hip dislocation. The modifications have made it easier for application and stable for fixation.