Skip to main content
Erschienen in: Journal of Children's Orthopaedics 6/2008

01.12.2008 | Original Clinical Article

Proximal femoral osteotomies in children using the Richards hip screw: techniques, outcome and subsequent removal

verfasst von: James A. Webb, Mohammed Almaiyah, Jim McVie, Richard J. Montgomery

Erschienen in: Journal of Children's Orthopaedics | Ausgabe 6/2008

Einloggen, um Zugang zu erhalten

Abstract

Introduction

We investigated the clinical and radiological outcome of proximal femoral osteotomies in children using the Richards hip screw. We also describe previously unreported techniques used in the insertion of the screw to aid satisfactory correction of the neck shaft angle and medialisation.

Methods

Seventy-two children undergoing 81 proximal femoral osteotomies under the care of the senior author over a 10-year period were reviewed.

Results

For the primary procedure, there was an overall complication rate of 5%. This included two (2.5%) cases requiring re-operation. There were no fractures and no long-term complications. For subsequent removal of the metalwork, the complication rate was 5%, with a re-operation rate of 1%.

Conclusion

We conclude that the Richards hip screw is a safe, atraumatic and easy-to-use method of fixation for proximal femoral osteotomies in children, with lower complication.
Literatur
1.
Zurück zum Zitat MacEwen GD, Shands AR Jr (1967) Oblique trochanteric osteotomy. J Bone Joint Surg Am 49:345–354 MacEwen GD, Shands AR Jr (1967) Oblique trochanteric osteotomy. J Bone Joint Surg Am 49:345–354
2.
Zurück zum Zitat Axer A (1965) Subtrochanteric osteotomy in the treatment of Perthes’ disease: a preliminary report. J Bone Joint Surg Br 47:489–499 Axer A (1965) Subtrochanteric osteotomy in the treatment of Perthes’ disease: a preliminary report. J Bone Joint Surg Br 47:489–499
3.
Zurück zum Zitat Canale ST, Holand RW (1983) Coventry screw fixation of osteotomies about the pediatric hip. J Pediatr Orthop 3:592–600CrossRef Canale ST, Holand RW (1983) Coventry screw fixation of osteotomies about the pediatric hip. J Pediatr Orthop 3:592–600CrossRef
4.
Zurück zum Zitat Kitakoji T, Hattori T, Iwata H (1999) Femoral varus osteotomy in Legg-Calvé-Perthes disease: points at operation to prevent residual problems. J Pediatr Orthop 19:76–81 Kitakoji T, Hattori T, Iwata H (1999) Femoral varus osteotomy in Legg-Calvé-Perthes disease: points at operation to prevent residual problems. J Pediatr Orthop 19:76–81
5.
Zurück zum Zitat Lloyd-Roberts GC, Catterall A, Salamon PB (1976) A controlled study of the indications for and the results of femoral osteotomy in Perthes’ disease. J Bone Joint Surg Br 58:31–36 Lloyd-Roberts GC, Catterall A, Salamon PB (1976) A controlled study of the indications for and the results of femoral osteotomy in Perthes’ disease. J Bone Joint Surg Br 58:31–36
6.
Zurück zum Zitat Canario AT, Williams L, Wientroub S, Catterall A, Lloyd-Roberts GC (1980) A controlled study of the results of femoral osteotomy in severe Perthes’ disease. J Bone Joint Surg Br 62:438–440 Canario AT, Williams L, Wientroub S, Catterall A, Lloyd-Roberts GC (1980) A controlled study of the results of femoral osteotomy in severe Perthes’ disease. J Bone Joint Surg Br 62:438–440
7.
Zurück zum Zitat Colyer RA (1980) Compression external fixation after biplane femoral trochanteric osteotomy for severe slipped capital femoral epiphysis. J Bone Joint Surg Am 62:557–560 Colyer RA (1980) Compression external fixation after biplane femoral trochanteric osteotomy for severe slipped capital femoral epiphysis. J Bone Joint Surg Am 62:557–560
8.
Zurück zum Zitat Ireland J, Newman PH (1978) Triplane osteotomy for severely slipped upper femoral epiphysis. J Bone Joint Surg Br 60:390–393 Ireland J, Newman PH (1978) Triplane osteotomy for severely slipped upper femoral epiphysis. J Bone Joint Surg Br 60:390–393
9.
Zurück zum Zitat Southwick WO (1972) Treatment of severely slipped upper femoral epiphysis by trochanteric osteotomy. AAOS Instructional Course Lectures 21:200–213 Southwick WO (1972) Treatment of severely slipped upper femoral epiphysis by trochanteric osteotomy. AAOS Instructional Course Lectures 21:200–213
10.
Zurück zum Zitat Southwick WO (1967) Osteotomy through the lesser trochanter for slipped capital femoral epiphysis. J Bone Joint Surg Am 49:807–835 Southwick WO (1967) Osteotomy through the lesser trochanter for slipped capital femoral epiphysis. J Bone Joint Surg Am 49:807–835
11.
Zurück zum Zitat Salvati EA, Robinson JH Jr, O’Down TJ (1980) Southwick osteotomy for severe chronic slipped capital femoral epiphysis: results and complications. J Bone Joint Surg Am 62:561–570 Salvati EA, Robinson JH Jr, O’Down TJ (1980) Southwick osteotomy for severe chronic slipped capital femoral epiphysis: results and complications. J Bone Joint Surg Am 62:561–570
12.
Zurück zum Zitat Eilert RE, MacEwan GD (1977) Varus derotational osteotomy of the femur in cerebral palsy. Clin Orthop Relat Res 125:168–172 Eilert RE, MacEwan GD (1977) Varus derotational osteotomy of the femur in cerebral palsy. Clin Orthop Relat Res 125:168–172
13.
Zurück zum Zitat Tylkowski CM, Rosenthal RK, Simon SR (1980) Proximal femoral osteotomy in cerebral palsy. Clin Orthop Relat Res 151:183–192 Tylkowski CM, Rosenthal RK, Simon SR (1980) Proximal femoral osteotomy in cerebral palsy. Clin Orthop Relat Res 151:183–192
14.
Zurück zum Zitat Weighill FJ (1976) The treatment of developmental coxa vara by abduction subtrochanteric and intertrochanteric femoral osteotomy with special reference to the role of adductor tenotomy. Clin Orthop Relat Res 116:116–124 Weighill FJ (1976) The treatment of developmental coxa vara by abduction subtrochanteric and intertrochanteric femoral osteotomy with special reference to the role of adductor tenotomy. Clin Orthop Relat Res 116:116–124
15.
Zurück zum Zitat Beauchesne R, Miller F, Moseley C (1992) Proximal femoral osteotomy using the AO fixed-angle blade plate. J Pediatr Orthop 12:735–740CrossRef Beauchesne R, Miller F, Moseley C (1992) Proximal femoral osteotomy using the AO fixed-angle blade plate. J Pediatr Orthop 12:735–740CrossRef
16.
Zurück zum Zitat Root L, Siegal T (1980) Osteotomy of the hip in children: posterior approach. J Bone Joint Surg Am 62:571–575 Root L, Siegal T (1980) Osteotomy of the hip in children: posterior approach. J Bone Joint Surg Am 62:571–575
17.
Zurück zum Zitat Hau R, Dickens DRV, Nattrass GR, O’Sullivan M, Torode IP, Graham HK (2000) Which implant for proximal femoral osteotomy in children? A comparison of the AO (ASIF) 90 degree fixed-angle blade plate and the Richards intermediate hip screw. J Pediatr Orthop 20:336–343 Hau R, Dickens DRV, Nattrass GR, O’Sullivan M, Torode IP, Graham HK (2000) Which implant for proximal femoral osteotomy in children? A comparison of the AO (ASIF) 90 degree fixed-angle blade plate and the Richards intermediate hip screw. J Pediatr Orthop 20:336–343
18.
Zurück zum Zitat Ito H, Minami A, Suzuki K, Matsuno T (2001) Three-dimensionally corrective external fixator system for proximal femoral osteotomy. J Pediatr Orthop 21:652–656 Ito H, Minami A, Suzuki K, Matsuno T (2001) Three-dimensionally corrective external fixator system for proximal femoral osteotomy. J Pediatr Orthop 21:652–656
19.
Zurück zum Zitat Canale ST, Beaty JH (1995) Operative pediatric orthopaedics. Mosby, St. Louis, pp 1–71 Canale ST, Beaty JH (1995) Operative pediatric orthopaedics. Mosby, St. Louis, pp 1–71
20.
Zurück zum Zitat Muller ME, Allgower M, Schneider R, Willenegger H (1979) Manual of internal fixation, 2nd edn. Springer, Berlin, pp 360–369CrossRef Muller ME, Allgower M, Schneider R, Willenegger H (1979) Manual of internal fixation, 2nd edn. Springer, Berlin, pp 360–369CrossRef
21.
Zurück zum Zitat Becker CE, Keeler KA, Kruse RW, Shah SA (1999) Complications of blade plate removal. J Pediatr Orthop 19:188–193CrossRef Becker CE, Keeler KA, Kruse RW, Shah SA (1999) Complications of blade plate removal. J Pediatr Orthop 19:188–193CrossRef
22.
Zurück zum Zitat Angliss R, Fujii G, Pickvance E, Wainwright AM, Benson MKD (2005) Surgical treatment of late developmental displacement of the hip: results after 33 years. J Bone Joint Surg 87-B:384–394CrossRef Angliss R, Fujii G, Pickvance E, Wainwright AM, Benson MKD (2005) Surgical treatment of late developmental displacement of the hip: results after 33 years. J Bone Joint Surg 87-B:384–394CrossRef
23.
Zurück zum Zitat Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104 Paley D (1990) Problems, obstacles, and complications of limb lengthening by the Ilizarov technique. Clin Orthop Relat Res 250:81–104
24.
Zurück zum Zitat Reimers J (1980) The stability of the hip in children. A radiological study of the results of muscle surgery in cerebral palsy. Acta Orthop Scand Suppl 184:1–100CrossRef Reimers J (1980) The stability of the hip in children. A radiological study of the results of muscle surgery in cerebral palsy. Acta Orthop Scand Suppl 184:1–100CrossRef
25.
Zurück zum Zitat McCarty M, Waugh R, McCallum HM, Montgomery RJ, Aszkenasy M (2001) Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit. Pediatr Radiol 31(9):646–649. doi:10.1007/s002470100515CrossRef McCarty M, Waugh R, McCallum HM, Montgomery RJ, Aszkenasy M (2001) Paediatric pelvic imaging: improvement in gonad shield placement by multidisciplinary audit. Pediatr Radiol 31(9):646–649. doi:10.​1007/​s002470100515CrossRef
26.
Zurück zum Zitat Waugh R, McCallum HM, McCarty M, Montgomery RJ, Aszkenasy OM (2001) Paediatric pelvic imaging: optimisation of dose and technique using digital grid-controlled pulsed fluoroscopy. Pediatr Radiol 31(5):368–373. doi:10.1007/s002470000425CrossRef Waugh R, McCallum HM, McCarty M, Montgomery RJ, Aszkenasy OM (2001) Paediatric pelvic imaging: optimisation of dose and technique using digital grid-controlled pulsed fluoroscopy. Pediatr Radiol 31(5):368–373. doi:10.​1007/​s002470000425CrossRef
27.
Zurück zum Zitat Staheli LT, Corbett M, Wyss C, King H (1985) Lower-extremity rotational problems in children. Normal values to guide management. J Bone Joint Surg Am 67(1):39–47 Staheli LT, Corbett M, Wyss C, King H (1985) Lower-extremity rotational problems in children. Normal values to guide management. J Bone Joint Surg Am 67(1):39–47
28.
Zurück zum Zitat Rehm A, Nanu A, Montgomery RJ (1994) A new technique of femoral osteotomy in cerebral palsy. J Bone Joint Surg 76B(Suppl 2)3:154 Rehm A, Nanu A, Montgomery RJ (1994) A new technique of femoral osteotomy in cerebral palsy. J Bone Joint Surg 76B(Suppl 2)3:154
29.
Zurück zum Zitat Montgomery RJ (2001) Which implant for proximal femoral osteotomy in children? J Pediatr Orthop 21:272CrossRef Montgomery RJ (2001) Which implant for proximal femoral osteotomy in children? J Pediatr Orthop 21:272CrossRef
31.
Zurück zum Zitat Kahle WK (1994) The case against routine metal removal. J Pediatr Orthop 14:229–237CrossRef Kahle WK (1994) The case against routine metal removal. J Pediatr Orthop 14:229–237CrossRef
32.
Zurück zum Zitat Schmalzried TP, Grogan TJ, Neumeier PA, Dorey FJ (1991) Metal removal in a pediatric population: benign procedure or necessary evil. J Pediatr Orthop 11:72–76CrossRef Schmalzried TP, Grogan TJ, Neumeier PA, Dorey FJ (1991) Metal removal in a pediatric population: benign procedure or necessary evil. J Pediatr Orthop 11:72–76CrossRef
33.
Zurück zum Zitat Swiontkowski MF (1983) Slipped capital femoral epiphysis: complications related to internal fixation. Orthopedics 6:705–712 Swiontkowski MF (1983) Slipped capital femoral epiphysis: complications related to internal fixation. Orthopedics 6:705–712
Metadaten
Titel
Proximal femoral osteotomies in children using the Richards hip screw: techniques, outcome and subsequent removal
verfasst von
James A. Webb
Mohammed Almaiyah
Jim McVie
Richard J. Montgomery
Publikationsdatum
01.12.2008
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Children's Orthopaedics / Ausgabe 6/2008
Print ISSN: 1863-2521
Elektronische ISSN: 1863-2548
DOI
https://doi.org/10.1007/s11832-008-0127-8

Weitere Artikel der Ausgabe 6/2008

Journal of Children's Orthopaedics 6/2008 Zur Ausgabe

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.