Coxa vara describes a deformity of the hip where the angle formed between the capital coxa vara: occasionally seen in severe osteoarthritis and coxa valga . coxa vara and vertical physis increases fragment in inferior femoral neck (looks like inverted-Y radiolucency); decreased femoral anteversion. Coxa Valga >˚. • Coxa Vara. Y’ ligament of Bigelow( iliofemoral) is the thickest of the ligaments, limits anterior.
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If you believe that this Physiopedia article is the primary source for the information you are refering to, you can vra the button below to access a related citation statement. Original Editor – Sofie De Coster. Coxa vara is varra a varus deformity of the femoral neck. Congenital coxa vara results in a decrease in metaphyseal bone as a result of abnormal maturation and ossification of proximal femoral chondrocyte.
As a result of congenital coxa varathe inferior medial area of the femoral neck may be fragmented. A progressive varus deformity might also occur in congenital coxa vara as well as excessive growth of the trochanter and shortening of the femoral neck. A review on the development of coxa vara by Currarino et al showed an association with spondylometaphyseal dysplasia, demonstrating that stimulated corner fractures were present in most instances.
Ashish Ranade et al also showed that a varus position of the neck is believed to prevent hip subluxation associated with femoral lengthening.
An associated dysplastic acetabulum can lead to a hip subluxation.
In this case study, the acetabulum is abnormal in coxa vara. Acetabular index AI and sourcil slope SS are significantly different than in the normal acetabulum. The most serious ones with high and long term morbidity being osteonecrosis and coxa vara.
A retrospective study of femoral neck fractures in children show the following complications: Premature epiphyseal closure is described as one of the ethiological factors of coxa vara. Another possible explanation for the high occurrence of coxa vara is the loss of reduction after initial fracture reduction of implant failure in unstable fractures.
Developmental coxa vara is a rare condition with an incidence of 1 in 25 live births.
Clinically, the condition presents itself as an abnormal, but painless gait pattern. A Trendelenburg limp is sometimes associated with unilateral coxa vara and a waddling gait is often seen when bilateral coxa vara is present. Patients varz coxa vara often show:. Patients may also show femoral retroversion or decreased anteversion.
Signs to look out for are as follows:. MRI can be used to visualise the epiphyseal plate, which may be widened in coxa vara. CT can be used to determine the degree of femoral anteversion or retroversion. AP radiographs in standing are taken, usually of both hips in a neutral position. Measuremenst are then taken: Subluxation in children is measured by the Migration Index and the Centre edge Angle.
Ángulo de Inclinación del Fémur en el Hombre y su Relación con la Coxa Vara y la Coxa Valga
The objective of medical interventions is to restore the neck-shaft angle and realigning ccoxa epiphysial plate to decrease shear forces and promote ossification of the femoral neck defect. This is achieved by performing a valgus osteotomy, with the valgus position of the femoral neck improving the action of the gluteus muscles, normalising the femoral neck angle, increasing total limb length and improving the joint congruence.
Literature is lacking, but surgical management appears to be the accepted treatment protocol for this condition. Due to the low incidence of coxa vara and even lower for coxa valga, there is little literature currently available.
Coxa vara and coxa valga: diagram | Radiology Case |
There are 3 types Coxa Vara, acquired, congenital and developmental, usually displaying greater acetabular dysplasia and an abnormal acetabulum.
Surgery is the most effective treatment protocol. In the case of acquired coxa vara from a fracture, the proximal femur and femoral neck need accurate reduction and rigid fixation to avoid potential serious complications.
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