Correction of proximal femoral deformities in children by a guided growth technique: A review

Abstract

BACKGROUND: After surgical treatment of proximal femoral deformities in children, secondary deformities can often develop. They can be corrected successfully by epiphysiodesis — a method of working with growth zones.

AIM: To analyze the literature about the development of epiphysiodesis, a proximal femoral technique, and the results of its use in pediatric patients with hip joint pathologies.

MATERIALS AND METHODS: The results of using epiphysiodesis for treating secondary deformities in children with hip joint pathologies were analyzed. The literature search was performed in open electronic scientific databases eLibrary and PubMed for the period from 1933 to 2022.

RESULTS: Most authors reported good and satisfactory results in the correction of secondary proximal femoral deformities in children. They also suggested that the development of these deformities could be prevented by epiphysiodesis in time frames, which should be chosen correctly. However, no consensus has been established on the timing of surgical intervention and methods of its implementation.

CONCLUSIONS: Proximal femoral deformities in children, such as valgus deformity of the femoral neck and its recurrence, consequences of Kalamchi type II avascular necrosis, and hypertrophy of the greater trochanter, were corrected for a long time by a complex surgical intervention–intertrochanteric osteotomy of the femur. Improvement in examination methods and a deeper understanding of the growth zone functioning of the proximal femur allow orthopedists to introduce into practice less invasive and less traumatic but effective methods for correcting these proximal femoral deformities by controlled blocking of the growth zones.

Keywords

congenital hip dislocation / developmental dysplasia of the hip / coxa valga / Legg–Calvé–Perthes disease / avascular necrosis of the femoral head / growth plates / greater trochanteric overgrowth / epiphysiodesis / hemiepiphysiodesis

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