Volume 3, 2017
|Number of page(s)||4|
|Published online||04 July 2017|
Proximal femoral derotation osteotomy for idiopathic excessive femoral anteversion and intoeing gait
Department of Orthopaedics Surgery, Addenbrookes Hospital, Hills Rd, Cambridge
CB2 0QQ, UK
* Corresponding author: firstname.lastname@example.org
Accepted: 18 May 2017
Aim: The purpose of this study is to assess the symptoms caused by excessive femoral anteversion and the outcomes of femoral derotation osteotomy.
Methods: We reviewed data on patients who underwent proximal femoral derotation osteotomy for symptomatic intoeing gait caused by femoral anteversion. Only symptomatic patients were considered for corrective derotation osteotomy. Degree of femoral anteversion was confirmed on computed tomography (CT) scan.
Results: Thirty-five extremities were operated in 21 patients with an average age of 13.3 (8–18) years. Mean follow-up was 16 months (6–36 months). Mean femoral anteversion angle was 40.8° (28°–53°). External rotation of extended hips improved significantly, from 30° to 51.8° (p < 0.0001). Mean foot progressing angle improved from 15.2° internally rotated preoperatively to 7.7° externally rotated. Intoeing completely resolved in all except two patients. Thirteen out of 21 children complained about tripping and frequent falling while running and playing sports, eight patients had hip pain while 13 children had knee pain preoperatively. Tripping, falling and hip pain resolved in all patients postoperatively, while three patients whose primary complaint was knee pain failed to improve postsurgery. Eighteen of the 21 parents were satisfied with the decision to perform surgical correction.
Conclusion: Excessive femoral anteversion can present with unexplained hip or knee pain refractory to conservative treatments. Careful assessment of lower limb malalignment is a valuable tool in such circumstances and derotation proximal femoral osteotomy can certainly be a procedure of choice in carefully selected cases.
Key words: Intoeing / Femoral anteversion / Femoral osteotomy
© The Authors, published by EDP Sciences, 2017
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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