Konjenital Kalça Çıkıklarında Varus Ameliyatı
Abstract
In congenital hip dislocations, pathological coxa valga is routinely corrected via varus osteotomy, often combined with derotation osteotomy, open reduction, or pelvic osteotomies. However, excessive correction may lead to “shepherd’s crook” deformity of the proximal femur. Biomechanical analysis of ten complex cases revealed that postoperative bending (“deflection”) increases if the resultant hip joint force (R) does not pass through bone substance and if the trochanter major apex lies above the femoral head center. To prevent these complications, (1) the distal fragment must be medialized so that R traverses bone, and (2) planned varus angles must keep the trochanter major level with or below the femoral head center. Clinical outcomes confirmed the mathematical model.
Keywords
congenital hip dislocation, varus osteotomy, biomechanics, coxa valga, femoral neck
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