Coxa Vara, Genu Varum, Genu Valgum. Under Gradts.

1. COXA VARA
GENU VARUM
GENU VALGUM
Dr.V.Sarthy
Asst Professor
Dept of Orthopaedics
SSSMCRI

2. Parts Of a Bone
epiphysis

3. Growing Bone

4. Growth plate

5. Growing Bone

6. Describing deformities….
Coxa.
Genu.
Cubitus.
Hallux.
Mannus.
Talipes.
Pes.
Etc….

7. Varus & Valgus

8. In relation of the DISTAL, part to the MID-LINE

9. Genu

10. Genu

11. Coxa

12. Cubitus
NORMAL VALGUS VARUS

13. Heel.

14. Hallux.

15. Coxa Vara
•The normal femoral neck–shaft angle is 160
degrees at birth, decreasing to 125 degrees in
adult life. An angle of less than 120 degrees is
called coxa vara.

16. COXA VARA
CONGENITAL ACQUIRED
• Defect of endochondral
ossification in the medial part of
the femoral neck.
• Coxa vara can develop if the
femoral neck bends or if it breaks.

17. Congenital Coxa Vara.

18. Management.
• H-E Angle 40 – 60 degree : OBSERVE
• >60 degree : Corrective VALGUS Osteotomy.

19. Acquired Coxa Vara.
In Children: Adults/ Any age:
•Rickets.
•Osteo Dystrophies.
•Perthes Disease.
•Epiphyseolysis.
•Osteomalacia.
•Fibrous Dysplasia.
•Infection.
•Tumor.
•Pagets Disease.
•Pathological Fracture.
•Fracture Malunion.

20. Treatment.
• Only if there is MARKED Shortening.
• Corrective Osteotomy.

21. Genu Varum & Genu Valgum
Knock Knees Bow Legs

22. BOW LEGS AND KNOCK KNEES IN CHILDREN
•Physiological bow legs and knock knees:
• Bow legs in babies and knock knees in 4-year-olds are so
common that they are considered to be normal stages of
development.

23. Physiological – Most of the time.

24. When to Worry?
• In the occasional case where, by the age of 10, the
deformity is still marked
• - (i.e. the intercondylar distance is more than 6 cm or
the intermalleolar distance more than 8 cm),
operative correction should be advised.

25. What to Measure:
Inter Malleolar Distance.
(< 8 cm)
Inter Condylar Distance.
(< 6 cm)

26. How to Treat?
•Hemi Epiphyseodesis.
• Stapling.
• Corrective Osteotomy.
• Distal Femoral
• Proximal Tibial.

27. Pathological Bow leg & Knock Knee.
Disorders which cause distorted epiphyseal and/or
physeal growth may give rise to bow leg or knock
knee:
• Skeletal dysplasias.
• The various types of Rickets.
• Injuries of the epiphyseal and physeal growth
cartilage.

28. Management.
• Treat the Primary cause if possible.
• If angulation is severe, operative correction will be
necessary, but it should be deferred until near the
end of growth lest the deformity recur with further
growth.

29. Corrective Osteotomy.

30. Blounts Disease.
• This is a progressive bow-leg deformity
associated with abnormal growth of the
posteromedial part of the proximal tibia.

31. Pathology.

32. Clinical Features:
•Over Weight Children.
• Early Walkers.
• Common among Negroid Children.
•Bilateral in 80%

33. X-Ray.
Metaphyseo – Diaphyseal Angle < 11 degrees - Normally)

34. Management.
• Progressing Deformity:
• Surgical Correction:
1. Corrective Osteotomy.
2. Elevation of the Epiphysis.
3. Excision of the bony bar & Fat pad placement.
4. Always perform a Fasciotomy to avoid Compartment
Syndrome.
5. If Shortening ensues- Perform Lengthening at a later stage.

35. Osteotomy & Epiphyseal Elevation.

36. Osteotomy, Epiphyseal Elevation.

37. Genu Varum & Valgum in Adults.
• Sequel to childhood deformities.
• Secondary to:
• Arthritis.
• Ligamentous Injuries.
• Fractures.
• Pagets Disease.

38. Management.
•With No Associated Arthritis:
Corrective Osteotomy.
•Uni Compartmental Arthritis:
• Corrective Osteotomy or Partial Joint
Replacement.
•Bi Comparmenntal Arthritis:
• Total Joint Replacement.

40. What is this?

41. Thank You.