Lz. Payne et Pa. Deluca, INTERTROCHANTERIC VERSUS SUPRACONDYLAR OSTEOTOMY FOR SEVERE FEMORAL ANTEVERSION, Journal of pediatric orthopedics, 14(1), 1994, pp. 39-44
Severe femoral anteversion may require operative correction if it resu
lts in cosmetic or functional disability. Complication rates less-than
-or-equal-to 15% have been reported after derotational osteotomy. We r
eport the results of 51 osteotomies in 27 patients with idiopathic fem
oral anteversion over a 15-year period at a major pediatric orthopaedi
c referral center. Thirty-four derotational osteotomies in 17 patients
were performed using a supracondylar technique with crossed-pin fixat
ion. There was a 14.7% complication rate. Sixteen osteotomies in 10 pa
tients were performed using an intertrochanteric osteotomy and blade-p
late fixation with the patient in the prone position; there were no re
ported complications. The intertrochanteric osteotomy allowed more acc
urate correction of the intoeing deformity and decreased the need for
postoperative immobilization. In addition, the more secure blade-plate
fixation benefits the active child >8 years of age who requires opera
tive correction of severe femoral anteversion.