Congenital Dysplasia Of The Hip Research Articles

Comparison of clinical and radiological outcomes for the anterior and medial approaches to open reduction in the treatment of bilateral developmental dysplasia of the hip: a systematic review protocol.

Developmental dysplasia of the hip (DDH) affects 1-3% of newborns and 20% of cases are bilateral. The optimal surgical management strategy for patients with bilateral DDH who fail bracing, closed reduction or present too late for these methods to be used is unclear. There are proponents of both medial approach open reduction (MAOR) and anterior approach open reduction (AOR); however, there is little evidence to inform this debate. We will perform a systematic review designed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol. We will search the medical and scientific databases including the grey and difficult to locate literature. The Medical Subject Headings "developmental dysplasia of the hip", "congenital dysplasia of the hip", "congenital hip dislocation", "developmental hip dislocation", and their abbreviations, "DDH" and "CDH" will be used, along with the qualifier "bilateral". Reviewers will independently screen records for inclusion and then independently extract dataon study design, population characteristics, details of operative intervention and outcomes from the selected records. Data will be synthesised and a meta-analysis performed if possible. If not possible we will analyse data according to Systematic Review without Meta-Analysis guidance. All studies will be assessed for risk of bias. For each outcome measure a summary of findings will be presented in a table with the overall quality of the recommendation assessed using the Grading of Recommendations Assessment Development and Evaluation approach. The decision to perform MAOR or AOR in patients with bilateral DDH who have failed conservative management is not well informed by the current literature. High-quality, comparative studies are exceptionally challenging to perform for this patient population and likely to be extremely uncommon. A systematic review provides the best opportunity to deliver the highest possible quality of evidence for bilateral DDH surgical management. The protocol has been registered in the International Prospective Register of Systematic Reviews (PROSPERO ID CRD42022362325).

THE KNEE-HIP-SPINE TRILEMMA IN PATIENTS WITH SEVERE CONGENITAL DYSPLASIA OF THE HIP UNDERGOING TOTAL HIP ARTHROPLASTY: 77 HIPS FOLLOWED UP FOR A MINIMUM OF FIVE YEARS

Pelvic bone defect in patients with severe congenital dysplasia of the hip (CDH) lead to abnormalities in lumbar spine and lower limb alignment that can determine total hip arthroplasty (THA) patients' outcome. These variables may be different in uni- or bilateral CDH.We compared the clinical outcome and the spinopelvic and lower limb radiological changes over time in patients undergoing THA due to uni- or bilateral CHD at a minimum follow-up of five years.Sixty-four patients (77 hips) undergoing THA due to severe CDH between 2006 and 2015 were analyzed: Group 1 consisted of 51 patients with unilateral CDH, and group 2, 113 patients (26 hips) with bilateral CDH. There were 32 females in group 1 and 18 in group 2 (p=0.6). The mean age was 41.6 years in group 1 and 53.6 in group 2 (p<0.001). We compared the hip, spine and knee clinical outcomes. The radiological analysis included the postoperative hip reconstruction, and the evolution of the coronal and sagittal spinopelvic parameters assessing the pelvic obliquity (PO) and the sacro-femoro-pubic (SFP) angles, and the knee mechanical axis evaluating the tibio-femoral angle (TFA).At latest follow-up, the mean Harris Hip Score was 88.6 in group 1 and 90.7 in group 2 (p=0.025). Postoperative leg length discrepancy of more than 5 mm was more frequent in group 1 (p=0.028). Postoperative lumbar back pain was reported in 23.4% of the cases and knee pain in 20.8%, however, there were no differences between groups. One supracondylar femoral osteotomy and one total knee arthroplasty were required. The radiological reconstruction of the hip was similar in both groups. The PO angle improved more in group 1 (p=0.01) from the preoperative to 6-weeks postoperative and was constant at 5 years. The SFP angle improved in both groups but there were no differences between groups (p=0.5). 30 patients in group 1 showed a TFA less than 10º and 17 in group 2 (p=0.7).Although the clinical outcome was better in terms of hip function in patients with bilateral CDH than those with unilateral CDH, the improvement in low back and knee pain was similar. Patients with unilateral dysplasia showed a better correction of the PO after THA. All spinopelvic and knee alignment parameters were corrected and maintained over time in most cases five years after THA.

Classics. Transiliac osteotomy in the treatment of congenital dysplasia of the hip

The author is presenting his experience in surgical reconstruction of the dysplastic acetabular roof. The reconstruction is combined with a simultaneous reduction of the subluxed hip. This method was under the author’s elaboration since 1927 and it was named by him as transiliac osteotomy in 1958. Detailed surgical technique is described.

A new test (Sacco Manni test 3) of congenital dysplasia of the HIP: A Cross Sectional and Analytic Study

Purpose Or Objective: Without a prompt diagnosis, congenital dysplasia of the hip in newborns can lead severe sequelae. Current screening strategies emphatize the use of ORTOLANI AND BARLOW tests, yet they exhibit low sensibility. The purpose of this study is to evaluate for a new test as a screening tool for congenital dysplasia of the hip. Methods: to evaluate the new test, a cross sectional and analytic study was performed with a non-probabilistic sampling method. Patients with either a positive ORTOLANI AND BARLOW TESTS were evaluated with the new test (Sacco Manni test 3) and hip ultrasounds. Controls were infants With negative ORTOLANI AND BARLOW and SACCOMANNI TESTs and also had an ultrasound performed. Results: CONGENITAL dysplasia of the hip was confirmed in 83 to 130 cases (64%), and 2 of 130 controls (2%). The new test had a sensitivity of 76% AND A specificity of 94% as compared to the ORTOLANI AND BARLOW TESTS (sensitivity 31 to 32 %, specificity 93 to 100% (p inferior to 0,05). Conclusion: this new test could serve as another clinical tool for the initial screening of congenital dysplasia of the hip in in fans or newborns. Its promising results against traditional screening procedures might potentially impact diagnosis and prognosis for patients with congenital dysplasia of hip.

Ethnic and sociodemographic correlates of developmental dysplasia of the hip in newborns from Yucatan, Mexico.

To provide an insight of the incidence of congenital developmental dysplasia of the hip in newborns from Yucatan born between 2015 and 2019 and analyze its association with maternal sociodemographic characteristics and neonatal, pregnancy and delivery related aspects. Retrospective, population-based study from Birth Registries database in Yucatan, Mexico between 2015 and 2019. Presence of hip dysplasia was described and analyzed considering three aspects (I) Maternal information (II) Pregnancy and birth (III) Neonatal examination. We obtained incidence rates from each year and the complete studied period. Association between hip dysplasia and maternal, neonatal and pregnancy/delivery variables was analyzed using logistic regression, unadjusted odds ratio and an adjusted model. Hip dysplasia occurred in 13 per 10 000 live births. Significant associations were found between hip dysplasia and maternal place of residence in a city <50 000 inhabitants, without a local clinic. Propensity to give birth to a neonate with hip dysplasia increased with maternal age and ethnicity, in female newborns and when total number of pregnancy consultations summed <5. Newborns with hip dysplasia were heavier and less susceptible to be delivered vaginally. Congenital developmental hip dysplasia was comparatively more frequent among offspring of Mayan women and suboptimal access to medical care during pregnancy. Female neonates were affected the most, those first-borns. Neonates with hip dysplasia were heavier and more susceptible to be born by cesarean section. Maternal, neonatal, and perinatal factors are associated with DDH in Yucatecan infants born during 2015-2019. Factors that describe living conditions seems to have a more important effect on the presence of this condition.

Unilateral absence of round ligament of femur - Cadaveric case report

Round ligament of femur is a pyramidal structure with apex attached to the fovea of the femoral head and its base blends with the transverse acetabular ligament. It is an intracapsular but extrasynovial structure. It is also called ligamentum teres femoris or foveal ligament. It transmits the acetabular branch of obturator artery and also acts as a secondary stabilizer of the hip joint by supplementing the other ligaments of the hip joint in extreme range of motion. Absence of round ligament of femur is a rare variation which can be unilateral or bilateral and prevalence is 2%–3%. It presents rarely as isolated entity or in association with congenital dysplasia of the hip. This report presents a rare variation of unilateral absence of round ligament of femur with minimal evidence of developmental dysplasia of the hip. During routine dissection of a middle-aged cadaver, on opening the hip joint cavity, the round ligament of femur was absent on the left side whereas, acetabular labrum and femoral head were normal. On the right side, the lower limb was normal in position and round ligament of femur was present in normal length and thickness. Awareness and knowledge of such a rare variation are important for radiologists and orthopedicians for better diagnosis and management of hip-related problems.

Clinical Outcomes of Conical Hip Prosthesis Used In Primary Total Hip Arthroplasty

Introduction: Congenital dysplasia of the hip, presence of intramedullary bony pedestals, and related pathologies present unique challenges to the orthopaedic surgeon when considering total hip arthroplasty (THA). In these circumstances, a conical prosthesis has proven to be effective. The purpose of this study is to report the short-term radiological and clinical outcomes of the Wagner Cone Prosthesis® (Zimmer Biomet, Warsaw, Indiana) utilized for a range of etiologies at a major North American healthcare system. Materials and Methods: A retrospective study was performed at a single healthcare system between 2007 and 2018. Demographic variables, including age, sex, and laterality, as well as surgical variables, including femoral head size, neck-shaft angle, stem diameter, surgical approach, and indication for THA, were collected for each hip. Radiographs were also examined for subsidence, limb length discrepancy (LLD), and Crowe classification if the hip was dysplastic. Results: Thirty-one THAs were performed using a Wagner Cone Prosthesis®. No intraoperative or postoperative implant-related complications were reported. Fourteen hips were dysplastic, and of these, 10 were classified as Crowe I, one as Crowe II, two as Crowe III, and one as Crowe IV. No implant was observed to have subsidence greater than 1cm. The average LLD following arthroplasty was 1.38mm ± 9.4mm shorter than the contralateral side. Conclusion: The Wagner Cone Prosthesis® serves as a useful implant for THA. In our sample, it had excellent survivorship, impressive postoperative radiographic measurements obtained from most recent follow up, minimal mean subsidence, and minimal complication rates.

Developmental anomalies and associated impairments in Saudi children with cerebral palsy: a registry-based, multicenter study

BackgroundThere are few epidemiological data to support rehabilitation programs for cerebral palsy (CP). Scarce international studies described the developmental anomalies (DAs) among children with CP. To our knowledge, the Arab countries did not publish data regarding this topic. This study aimed to describe the percentage of DAs among children with CP and detect the association between clinical subtypes and impairment severity in children with various DAs. We collected registry data of 679 children with cerebral palsy, between 2014 and 2019, from Armed Forces Hospitals, Taif, Kingdom of Saudi Arabia (KSA). We recorded demographic, perinatal, postnatal, developmental anomalies, subtypes, and impairment characteristics. We utilized the chi-square test to calculate the differences between groups.ResultsWe reported significant differences between the children with and without anomalies regarding the percentages of consanguinity, preterm labor, low birth weight, and neonatal intensive care unit admission (P = 0.001, 0.002, 0.003, 0.005, respectively). Congenital dysplasia of the hip and hydrocephalus was the most frequent skeletal and nervous anomalies among children with DAs (19.1% and 12.8%, respectively). The spastic bilateral pattern was significantly higher among children with skeletal anomalies than the central nervous system/other groups (P < 0.001). The nervous anomalies group had higher frequencies of severe intellectual, motor, speech, and visual disabilities and a higher percentage of seizures than all other groups.ConclusionsThe frequency of children with anomalies in this study was comparable to previous studies. Children with CP and nervous system anomalies had more severe motor disabilities and associated impairments.

Developmental Dysplasia of the Hip (DDH) in Saudi Arabia: Time to Wake up. A Systematic Review (1980-2018)

The objective of this systematic literature review was to assess the incidence of DDH among the Saudi Arabian population. Methods: A systematic review was performed for all the published articles in the English language literature on DDH in Saudi Arabia. Data sources were PubMed Medline (1980-2018) (http://www.ncbi.nlm.nih.gov/pubmed/), Ovid Medline (1980-2018), EMBASE MEDLINE (1980 to May 2018), EMBASE (1991 to May 2018), the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews, the Science Citation Index (1966 to May 2018), published data from the Saudi Medical Journal (1985-2018) and Annals of Saudi Medicine (1985-2018). The author independently reviewed articles and abstracted the data. The key words used were Saudi Arabia developmental dysplasia of the hip ORDDH, congenital hip dislocation or congenital subluxation of the hip, and congenital dysplasia of the hip. Results: The authors identified 18 potentially relevant articles published in the last 38 years, and 10 met the inclusion criteria. The 10 studies analyzed included 2037 studies of infants diagnosed with DDH; and they gave an average incidence of 10.46/1000. Two studies (303 subjects) did not report the affected gender; in the remaining 338 were boys and 1396 were girls and one study did not report the side of affection. The majority presented after 12 months of age. The right side was affected in 532 (27.2%) affected, 734 (37.6%) were left side and 687 (35.2%) infants were affected bilaterally. Consanguinity, breech presentation, and family history were found to be the risk factors in 32.9%, 17.3%, and 23.6% of the patients, respectively. Conclusions: There is paucity of available literature on DDH in Saudi Arabia. New strategies have to be developed that include mandatory screening programs in all hospitals (private and public) so that more children can be treated by nonsurgical methods.

Evaluation of Aid to Diagnosis for Congenital Dysplasia of the Hip in General Practice

Evaluation of Aid to Diagnosis for Congenital Dysplasia of the Hip in General Practice

Classifications in Brief: The Hartofilakidis Classification of Developmental Dysplasia of the Hip

Classifications in Brief: The Hartofilakidis Classification of Developmental Dysplasia of the Hip

Long-term survival of the cemented M\xfcller CDH stem: a minimum follow-up of 10\xa0years

IntroductionTotal hip arthroplasty in patients with altered anatomy of the hip and femur, such as in congenital dysplasia of the hip, is challenging and often requires specially designed stems. Müller straight stems have shown excellent long-term results; however, long-term data on the analogous cemented Müller CDH stem are still missing. The aim of this study was to analyze long-term survival, identify potential risk factors for aseptic loosening, and analyze radiological outcome of the cemented Müller CDH stems.Materials and methodsBetween 01/1985 and 06/2005, 95 Müller CDH stems (Zimmer, Winterthur, Switzerland) made up of 3 different materials were cemented using 2 different bone cements: 38 of stainless steel/high-viscosity cement, 31 of a cobalt-chrome-based alloy (CoCr)/low-viscosity cement, and 26 of a titanium-based alloy (Ti)/low-viscosity cement. All patients had a prospective clinical and radiological follow-up according to the standards of our institution. The cumulative incidence for revision of the stem was calculated using a competing risk model. To identify demographic and implant-related risk factors for aseptic loosening of the stem, a multivariate regression model for competing risks was performed.ResultsThe cumulative risk of revision at 15 years was 12.5% (95% CI 6.6–20.5%) for aseptic loosening of the stem as endpoint, with marked differences for the various stem materials used: stainless steel 2.7% (0.2–12.3%), CoCr 12.9% (4.0–27.3%), and Ti 24.5% (9.6–43.1%). Regression modeling revealed that Ti stems in combination with low-viscosity cement (HR 10.2) and implantation with an axis deviation greater than 3° (HR 3.8) are risk factors for aseptic loosening.ConclusionsLong-term survival of the cemented Müller CDH stem is comparable to other Müller-type straight stems and uncemented implants. Similar to the original Ti Müller straight stem, the Ti Müller CDH stem also showed an increased risk for aseptic loosening and should, therefore, no longer be used.

Functional Outcome of Crowe IV Congenital Dysplasia of the Hip Managed by Total Hip Arthroplasty with Subtrochanteric Osteotomy

Functional Outcome of Crowe IV Congenital Dysplasia of the Hip Managed by Total Hip Arthroplasty with Subtrochanteric Osteotomy

Is a short stem suitable for patients with hip dysplasia? A report on technical problems encountered during femoral reconstruction.

A wide variety of stems have been used for the treatment of osteoarthritis secondary to advanced hip dysplasia. Since evidence for using short stems in dysplastic hips is limited, we planned to analyse the technical problems encountered when reconstructing the proximal femur of patients with osteoarthritis secondary to congenital dysplasia of the hip treated with total hip arthroplasty (THA) using a type 2B short stem. We prospectively analysed 17 patients (22 hips) treated with primary THA performed with a single-branded short uncemented stem with metaphyseal fixation (MiniHip™; Corin). We excluded cases in which other type of stems were used, or in which retrospective data was only available. Mean follow-up was 41.22 months (minimum 24). We analysed clinical outcome using the modified Harris Hip Score (mHHS) and pain using the visual analogue scale (VAS). Radiographs were examined in order to determine causes of complications and revision surgery. All patients showed statistically significant improvement when preoperative and postoperative values for mHHS (54.19 vs. 94.57; p = 0.0001) and for pain VAS (8.71 vs. 0.71; p = 0.0003) were compared. No cases of thigh pain, instability or infection were found. 1 case of acetabular cup loosening and 1 case of periprosthetic fracture were diagnosed at 8 months and 45 days, respectively. Overall survival was 84.7% at 5 years (CI 95%, 64.4-105.3) with revision for any reason as an end point. When stem performance was separately evaluated, it showed a survival rate of 100% at 5 years with revision for aseptic loosening as an end point. THA with a type 2B short stem for the treatment of dysplastic osteoarthritis showed very few technical intraoperative problems, being a useful alternative for femoral reconstruction.

A Study on the Incidence of Avascular Necrosis Following Closed Reduction of the Dislocated Hip in Children with Congenital Dysplasia of the Hip: a Suggestion on Clinical Management

Background: Our district general hospital is one of two providers of elective paediatric orthopaedic services to a rural population with an annual live birth rate of approximately 5000 per year. The preferred practice in our hospital for dislocated hips in cases of congenital dysplasia of the hip (CDH) is to place the child in traction for 2 weeks then perform an arthrogram and closed reduction followed by the application of a hip spica. We wanted to evaluate the incidence of a vascular necrosis (AVN) of the femoral head following closed reduction of the hip. Methods: We have retrospectively reviewed all case notes for patients with congenital dysplastic hips (CDH) that had dislocated hips over a 20 year period from 1993-2013. Data was collected from clinic letters and radiographs. Results: There were 34 children with CDH and dislocated hips. The mean (±S.D) age at closed reduction was 14(±6) months. The mean follow up period was to 6(±3) years. One patient had features of AVN noted on radiographs at age 7 years (2.9%). This patient’s dislocated hip was reduced closed at age 8 months. In our series only 3 patients required open reduction. Of these 2 were followed by femoral derotation osteotomies. All these 3 patients presented with dislocated hips at greater than 15 months of age. Clinically all patients were functioning with no restrictions at last follow up Conclusion: We have treated children with arthrogram and closed reduction of the hip from the age of 4 months to 33 months resulting in one case of AVN in a child treated at 8 months old. This gives an AVN rate of 1 in 34 (2.9%). We would recommend this to be an acceptable method of management with a very low rate of AVN.

Short term clinical outcome of total hip arthroplasty for the treatment of Crowe IV congenital dysplasia of the hip in adults

To evaluate the short term clinical effects and surgery methods of the total hip arthroplasty (THA)for the treatment of Crowe type IV congenital dysplasia of hip (CDH) in adults. From March 2013 to March 2015, 20 patients (20 hips) with Crowe type IV CDH in adults were underwent THA, including 4 males and 16 females, with an average age of 52 years old ranged from 32 to 68 years old. All the cementless acetabular cups were placed at the original anatomic location. S-ROM prosthesis was adopted together with subtrochanteric transverse osteotomy in femoral side. All the patients were evaluated by using the Modified Harris Hip Score. Radiographic evaluations were made preoperatively and during follow up. The incisions were healed by first intention. There was no hip dislocation events and venous thrombosis occurred. All patients were followed up for 8 to 60 months with an average of 38.1 months. Postoperative X ray films showed all acetabular prosthesis were in true acetabulum. No nonunion and loosening were found in all patients. Harris score at final follow up improved from preoperative 50.90±9.35 to postoperative 90.25±3.16. The difference was statistically significant (P<0.05). There were 1 patient with femoral split fracture, 1 patient with nerve injury, 1 patient with heterotopic ossification of Brooker I. The hip function of all patients was good, the pain was disappeared. THA with S-ROM prosthesis and subtrochanteric osteotomy is an effective method for the treatment of Crowe type IV CDH in adults. The recent clinical curative effect is satisfied.

A clinical comparative study of anatomic parameters before and after total hip replacement on congenital dysplasia.

[Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I–III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I–III).

Frequency of hospitalization in patients diagnosed with congenital talipes equinovarus (CTEV)

Abstract Introduction. Congenital talipes equinovarus (CTEV), also called clubfoot is the second after congenital dysplasia of the hip (CDH) most frequently occurring congenital limb defect. In Europe the deformity affects 1-2 newborns in 1000 live births. Aim. The aim of the study was to determine frequency of the deformity among other reasons for hospitalization, as well as depicting the profile of patients treated for clubfoot. Material and methods. Study method was the analysis of medical documentation from two Orthopaedic Wards of Prof. Antoni Gębala Children’s Hospital of Lublin. Medical records of patients treated for congenital talipes equinovarus (IDC 10-Q66.0) between 2008 and 2013 were the study material. Results. Results of the study show that in the analyzed period of time 310 children were hospitalized for clubfoot in hospotal. 39.35% (n=122) of the total number of patients were girls and 60.65% (n=188) were boys. The average age of patients was 3.69 years, (Me=1.09 years). Average age of girls was 4.17 (Me=1.35 years) and boys 3.89 (Me=0.83 years). The most numerous group consisted of infants up to 1 year (n=154; 49.68%). Conclusions. Clubfoot affects boys twice as often as girls. Moreover, in the examined hospital the average length of stay for patients with clubfoot has decreased. The research reveals that the average hospitalization length in children with congenital talipes equinovarus is systematically decreasing. The study shows that the number of patients being admitted to the Children’s Orthopedics Institute of the Hospital is increasing while the number of patients with clubfoot remains on the same level.

A novel splice-site mutation in theAAGABgene segregates with hereditary punctate palmoplantar keratoderma and congenital dysplasia of the hip in a large family

Palmoplantar keratoderma punctata (PPKP) is a heterogeneous group of disorders characterized by hyperkeratotic papules occurring over the palms and soles during adolescence. PPKP type 1, also known as PPKP Buschke-Fischer-Brauer type, was recently found to result from mutations in the AAGAB gene, encoding the p34 protein. PPKP type 1 is usually not associated with extracutaneous features. To investigate a large family in which PPKP1 was present in association with congenital dysplasia of the hip (CDH). A combination of direct sequencing of candidate genes and reverse-transcription PCR was used to identify the molecular basis underlying the clinical features displayed by the patients. Direct sequencing showed a novel intronic mutation in AAGAB, which was found to cosegregate with PPKP and CDH throughout the family. The mutation was found to result in aberrant RNA splicing, leading to exon 4 skipping. This observation suggests either the existence of a CDH-associated gene in the vicinity of AAGAB, or a hitherto unrecognized role for p34 during skeletal development.

Midterm Results After Subtrochanteric End-to-Side Valgization Osteotomy in Severe Infantile Coxa Vara

For the treatment of the severe infantile coxa vara it is mandatory for the orthopaedic surgeon to observe the mechanobiology of the growing hip before and after the surgical intervention. We hereby would like to present our experiences with the subtrochanteric end-to-side valgization osteotomy and to compare the procedure with the alternatively used Y-shaped osteotomy as described by Pauwels. Thirteen patients (20 hips) who had undergone subtrochanteric end-to-side valgization were followed for a mean 6.2 years (range, 0.8 to 12.8 y). At the time of surgery the mean age was 7.1 years (range, 2.0 to 13.3 y), last follow-up examination was performed at a mean of 13.4 years of age (range, 5.1 to 18.3 y). The deformities were etiologically based on 5 entities: congenital coxa vara (n=1), osteochondrodysplasias (n=12), postosteomyelitic coxa vara (n=5), and avascular femoral head necrosis in the course of congenital dysplasia of the hip (n=2). The follow-up rate was 100%.In addition, we analyzed a total of 93 pelvic radiographies with a total of 139 hip joints. Thirty angles and distances were assessed according to parameters described in the literature. Although preoperatively 12 patients presented with a positive Trendelenburg's sign, it was only present postoperatively in 2 patients. Duchenne's limp reduced from 10 to 1. All of the 15 preoperatively apparent nonunions could be healed by means of surgery. Two hips redeveloped pathologically lowered collodiaphyseal angles postoperatively, one of which had to undergo revision surgery. Preoperatively 15 out of 20 patients (75%) showed nonunions all of which healed after surgery. No recurrence could be seen at the time of the last follow-up.The following angles were assessed on plain radiographies of the pelvis preoperatively and directly postoperatively as well as on the last follow-up at a mean of 85 months: CCD-angle 98 degrees/156 degrees/144 degrees, EY-angle 55 degrees/5 degrees/15.7 degrees, AY-angle 32 degrees/75 degrees/66 degrees, CE-angle 20 degrees/25 degrees/18 degrees, AC-angle 20 degrees/18 degrees/20 degrees. The articulotrochanteric distance was 5 mm/26 mm/14 mm. The subtrochanteric end-to-side valgization osteotomy showed to be highly effective in the management of the infantile coxa vara, improving the clinical impairment of the patients postoperatively. All of the preoperatively present nonunions showed osseous consolidation at follow-up examination. Only minor revarization tendencies could be found. The procedure is technically less demanding, safer and more efficient regarding the lengthening of the affected limb in comparison to the Y-shaped intertrochanteric osteotomy as described by Pauwels. Case-control study (EBM-level III).