Varus Derotation Osteotomy of the Proximal Femur in Neuromuscular Children Using a Locking Plate-Surgical Technique and Initial Results
Case Series | Volume 11 | Issue 2 | May-August 2025 | Page: 16-20 | Njalalle Baraza, Mordicai Ating’a
DOI- https://doi.org/10.13107/ijpo.2025.v11.i02.232
Open Access License: CC BY-NC 4.0
Copyright Statement: Copyright © 2025; The Author(s).
Submitted: 21/06/2024; Reviewed: 18/07/2024; Accepted: 27/05/2025; Published: 10/08/2025
Authors: Njalalle Baraza FRCS (Tr & Orth) [1], Mordicai Ating’a FRCS (Tr & Orth) [1]
[1] Department of Trauma and Orthopaedics, Aga Khan University, 3rd Parklands Avenue, P.O. Box 30270, GPO 00100, Nairobi, Kenya
Address of Correspondence
Dr. Njalalle Baraza,
Department of Trauma and Orthopaedics, Aga Khan University, 3rd Parklands Avenue, P.O. Box 30270, GPO 00100, Nairobi, Kenya
E-mail: njaleb@doctors.org.uk
Abstract
Introduction: Hip dysplasia affects up to 33% of children with neuromuscular disease. The main objective of treatment is improvement of femoral head coverage. Depending on the severity of dysplasia, treatment required may range from casting in abduction to salvage procedures including excision arthroplasty. The most commonly employed surgical procedure is a varus derotation osteotomy (VDRO) which is usually undertaken using a fixed angle blade plate, with or without a pelvic osteotomy. Unfortunately these implants are not always available. We therefore developed a novel technique using a locally available locking reconstruction plate to perform VDRO surgery, and present our initial results following the use of this technique.
Methods: Six hip in four patients of GMFCS IV or V suffering from hip dysplasia were included in the study. Pre and postoperative Reimers migration percentage (MP) was measured. In the three hips that underwent pelvic (Dega) osteotomy, the acetabular index (AI) was also measured. A paired t-test for non-parametric data was used to determine statistical significance.
Results: At an average of 8 months follow up, the pre-op MP had reduced from 64% to 23.3% (p=0.026). In the hips who had Dega osteotomy, the AI went down from 33.3 degrees to 23.3 degrees (p=0.013) at an average of 5 months follow up.
Conclusion: In the absence of a blade plate, the novel technique described is an effective alternative in performing VDRO surgery.
Keywords: Varus derotation osteotomy, VDRO, Neuromuscular hip, Hip dysplasia, Cerebral palsy, Hip surgery
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| How to Cite this Article: Baraza N, Ating’a M. Varus Derotation Osteotomy of the Proximal Femur in Neuromuscular Children Using a Locking Plate-Surgical Technique and Initial Results. International Journal of Paediatric Orthopaedics . May-August 2025; 11(2):16-20. |
