The long term (8-12 years) results of valgus and lengthening osteotomy of the femoral neck

Shortening of the femoral neck and proximal displacement of the greater tro chanter are the principal complications following avascular necrosis of the capital epiphysis head in early childhood. We report here the longterm fol low-up of a series of osteotomies performed to lengthen the femoral neck an d thus to restore the normal anatomy and function of the hip joint. Out of a sample of 24 patients, 15 (62.5%) were reviewed at the end of a mean foll ow-up of 10 years and 2 months. Fourteen of them (93.3%) had originally com plained of pain on walking which varied in severity. After the operation, f ive were free from pain at the end of the follow-up, 9 still experienced pa in on walking, and 1 also reported pain at rest. Before the operation, a po sitive Trendelenburg's sign was found in 8 of the patients. This was still present in 2 at follow-up. The average perpendicular distance from the cent er of the femoral head to a horizontal plane passing through the tip of the greater trochanter (the centro-trochanteric distance) was reduced from 33 mm to 7 mm. Apart from correcting the anatomical deformity, it is suggested that this operation may well provide lasting relief from pain and increase the power of the abductor muscles. It may also delay the onset of osteoart hritic change and in this way postpone the necessity for an endoprosthesis.