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Re: Congenital coxa vara
послал Myles Clough 18 Июнь 2005, 10:02
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The best I could do with a MeSH search on the subject is "coxa vara" osteotomy which yields over 100 papers. Much of this is paediatric orthopaedic literature. A much more restricted collection (4 papers) came from "coxa vara" osteotomy Pauwels Note spelling difference. It never used to matter but mis-spelled terms now are a trap for over-eager orthogeeks!
Clinically, I wonder about the source of the pain. If the patient has arthrosis of such severity that symptomatic treatment in not enough I would be concerned that altering the mechanics by doing an osteotomy would have limited effect and make eventual THR more difficult. I would suggest injecting some local anaesthetic into one hip. If there is full relief of pain I would consider holding out for a THR when the symptoms become that dominant.
When THR is inevitable but I would like to defer it as long as possible, I consider intra-articular cortisone.
Myles Clough
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