The reciprocal ledge closing wedge osteotomy for post traumatic coxa vara

Area of Science:

• Orthopedic surgery
• Biomechanical engineering

Background:

• Coxa vara, a condition characterized by an increased femoral neck-shaft angle, can lead to hip instability and pain.
• Traditional surgical interventions for coxa vara may involve complex osteotomies with varying degrees of success in restoring biomechanical alignment and stability.

Purpose of the Study:

• To present a novel proximal femoral osteotomy technique utilizing reciprocal bone ledges.
• To evaluate the efficacy of this technique in improving bone contact, stability, and clinical outcomes in patients with coxa vara.

Main Methods:

• A reciprocal ledge osteotomy was performed on 5 patients diagnosed with coxa vara over a 3-year period.
• The technique involves retaining bone ledges in a reciprocal position to maximize bone-to-bone contact and enhance rotational stability.

Main Results:

• The procedure resulted in an average femoral length increase of 1.5 cm and an average improvement in the neck-shaft angle of 30°.
• The average Harris hip score significantly improved from 63 to 82 post-operatively.
• The technique demonstrated reduced technical demand and converted shear forces into stabilizing forces.

Conclusions:

• The reciprocal ledge osteotomy is a technically straightforward and effective method for treating coxa vara.
• This technique enhances femoral stability, simplifies the use of dynamic hip screw (DHS) implants by mitigating rotational forces, and improves patient-reported functional outcomes.