The fate of the capital femoral physis and acetabular development in developmental coxa vara.

Abstract

Twenty-two hips in 15 children with the diagnosis of developmental coxa vara were retrospectively reviewed regarding the fate of acetabular development and physeal growth. The relationship of acetabular development to surgical correction of neck-shaft angle and the frequency of plate closure following surgery were investigated. Acetabular depth was found to improve if neck-shaft angle correction exceeded 140 degrees and did not improve if correction was less than 140 degrees. Capital physeal closure occurred in 89% of hips following valgus osteotomy and was not related to physeal injury during surgery. Normal acetabular development is not stimulated by the proximal femoral configuration of coxa vara and will not improve postosteotomy unless adequate valgus correction is achieved. Premature capital femoral physeal closure is a frequent sequelae of valgus osteotomy leading to relative greater trochanteric overgrowth and development of leg length discrepancy.