Why the study?
How do varus-derotation osteotomy and innominate osteotomy affect femoral head coverage and joint reaction forces compared to normal hips in a computerized model?
How do varus-derotation osteotomy and innominate osteotomy affect femoral head coverage and joint reaction forces compared to normal hips in a computerized model?
In a computerized model, neither varus-derotation nor innominate osteotomy provided complete coverage of the proximal femoral epiphysis, with differing effects on anterior coverage and shear forces.
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Neither osteotomy fully covers the epiphysis in this model; leaves open combined approaches for pediatric hip dysplasia.
Using a computerized model derived from anatomic specimens, coverage of the femoral head by the acetabulum during the gain cycle was studied and compared for normal hips, varus-derotation osteotomy, and innominate osteotomy (Salter). Theoretical estimates of joint reaction force were also studied during the gain cycle for the three conditions. The entire proximal femoral epiphysis was never covered by the acetabulum with any of these procedures. Innominate osteotomy gave better anterior coverage (with resultant poorer posterior coverage) than the femoral procedure. Varus-derotation osteotomy increased medial shear force at the epiphyseal plate to twice body weight, but in all cases the major component of force was normal to the epiphyseal plate (compression) rather than parallel to it (shear).
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George T. Rab (1981) studied this question.
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