INTERTROCHANTERIC VERSUS SUPRACONDYLAR OSTEOTOMY FOR SEVERE FEMORAL ANTEVERSION

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.