(v) Proximal femoral osteotomy in childhood

SummaryAbnormalities of the proximal femur in children range from teratologic hip dislocation and congenital coxa vara seen at birth to acquired disorders such as Legg–Calve–Perthes disease and slipped capital femoral epiphysis in later life. Left untreated, these conditions may lead to long-term morbidity in adulthood, ranging from early degenerative joint disease to complete inability to walk. However, treatment itself can be associated with significant complications such as avascular necrosis of the femoral head and chondrolysis, as well as the general risks of surgery. Optimal treatment requires careful consideration and planning and, importantly, involvement of parents in the decision-making process. Many of these conditions can be treated with a readjustment osteotomy of the proximal femur sometimes associated with a pelvic osteotomy. Prompt and timely intervention in the hands of an experienced surgeon can produce excellent results.