Using the Ilizarov technique for the correction of coxa vara

Abstract

Background and objective: Coxa vara was treated previously by subtrochanteric and inter-trochanteric valgus osteotomies with internal fixation. Recently; more attention was paid for achieving corrections of limb deformities and length discrepancies through less invasive means using external fixator systems including Ilizarov fixation. This study aimed to describe the performance of Ilizarov fixation technique in the surgical correction of coxa vara of different etiologies and limb lengthening. Methods: In this case series study, nine patients (11 hips) with coxa vara of different etiologies were treated surgically by sub-trochanteric osteotomy done percutaneously with the use of Ilizarov fixation device, in 15 months at Erbil teaching hospital. Patients between four and ten years of age with coxa vara with neck – shaft angle less than 120° or Hilgenreiner epiphyseal angle of more than 40° were included in this study. Results: All osteotomies achieved the targeted correction in the Hilgenreiner –epiphyseal angle and the neck-shaft angle with a P value <0.001. All osteotomies healed primarily and on follow-up, no intra-operative complications developed, and no patient needed the post-operative blood transfusion. Three patients needed limb lengthening, one patient needed shelf osteotomy, and two patients had superficial pin tract infection. Four patients had postoperative knee stiffness which resolved completely. Radiological analysis revealed a maintained improvement in the Hilgenreiner-epiphyseal angle and neck-shaft angle. Conclusion: Ilizarov technique is a safe and less invasive technique for the surgical management of coxa vara of different etiologies and limb length discrepancy.