Proximal Femur Guided Growth: A Systematic Review.

Journal of surgical orthopaedic advances Pub Date : 2024-01-01

Joshua C Tadlock, Michael D Eckhoff, Hunter R Graver, Tyler H Doty, Tyler C Nicholson, EStephan J Garcia

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Abstract

Children with cerebral palsy (CP) and those with avascular necosis (AVN) after treatment of developmental hip dysplasia (DDH) are at risk of developing coxa valga. Proximal femur guided growth is a minimally invasive option to correct this deformity. A systematic review of articles that described treatment of coxa valga with proximal femur guided growth (PFGG) and reporting on primary radiographic outcomes, demographic variables, surgical variables and complications. One hundred and seventy-nine hips underwent PFGG (117 with CP and 62 with lateral overgrowth). Average age at surgery was 8.1 years; average follow-up was 52.5 months. Migration percentage improved from 11.2% (p < 0.0001). Neck-shaft angle improved by 11.9° (p < 0.0001). The most common complication was screw growth out of the physis (30% of cases). PFGG can correct coxa valga, improve radiographic parameters, and in children with CP prevent further subluxation. This technique modulates proximal femur growth, induces changes to the acetabulum and can correct valgus deformity. Evidence Level III. (Journal of Surgical Orthopaedic Advances 32(4):049-052, 2024).

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股骨近端引导生长：系统回顾

脑性瘫痪（CP）患儿和发育性髋关节发育不良（DDH）患儿在接受治疗后出现血管性坏死（AVN），有可能发展为髋臼畸形（coxa valga）。股骨近端引导生长是矫正这种畸形的一种微创方法。我们对使用股骨近端引导生长（PFGG）治疗髋臼畸形的文章进行了系统性回顾，并报告了主要的放射学结果、人口统计学变量、手术变量和并发症。179个髋关节接受了PFGG手术（117个患有CP，62个患有侧方过度生长）。手术平均年龄为 8.1 岁，平均随访时间为 52.5 个月。迁移率从 11.2% 提高到了 11.2%（P < 0.0001）。颈轴角改善了11.9°（P < 0.0001）。最常见的并发症是螺钉脱出椎体（30%的病例）。PFGG 可以矫正髋臼，改善放射学参数，并防止 CP 儿童进一步发生半脱位。该技术可调节股骨近端生长，促使髋臼发生变化，并能矫正外翻畸形。证据等级 III。(外科骨科进展杂志》32（4）：049-052，2024 年）。

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Journal of surgical orthopaedic advances

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