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.
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.
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.
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.