1. Sunit Hazra MS Prof Hae Ryong Song MD PhD
Coxa Vara in a Patient of Osteopetrosis – Treated Successful by Valgus Subtrochanteric Osteotomy
Sunit Hazra MS
Prof Hae Ryong Song MD PhD

2. Introduction Osteopetrosis –
Defect in osteoclastic resorption --sclerotic bones
Infantile malignant / adult benign ( type I,II)
Autosomal recessive/ dominant
Multiple transverse / short oblique fractures

3. Case description A 7 year male Adult benign Osteopetrosis
Coxa vara (R)ICNF # (2001)- CR&IF by
cannulated screws
LLD of 2.5 cm

4. Past H/O- subtrochanteric # L femur-- 2006

5. Treated by OR & IF

6. Fracture united

7. Coxa vara
Neck shaft angle-96’

8. Subtrochanteric valgus osteotomy

9. Follow up at 6 months post. op
Fracture union in progress
LLD  1cm shoe raise
Neck shaft angle 130°

10. Final Radiograph
Neck Shaft angle: 122° (130 °)
LLD: 3.6cm (1cm)

11. Discussion Coxa vara – osteopetrosis
King and Lovejoy-- used a Bosworth spline to fix a valgus osteotomy - "healing occurred normal rate,"
Kaibara et al -- proximal femoral osteotomy
Healing normal
Steinwender et al -- bilateral nonunited femoral neck fractures and coxa vara-- Valgus osteotomies - successful but technically difficult

12. Implant used King and Lovejoy used a Bosworth spline
Steinwender et al. -- Internal fixation - K-wires for one hip and a blade-plate for the other.
Plate and screw fixation was used by Milgram and Jasty

13. Armstrong, D et al 1999 J Pediatr Orthop. 1999
coxa vara -- valgus osteotomy, preferably during childhood when the bone may be more amenable to fixation.
Parents -- forewarned -- risks of delayed union or nonunion

14. A period of bed rest or no weight bearing may facilitate osteotomy and fixation
Do have potential to recur should ordinarily require close follow-up for several years.

15. Conclusion
Coxa vara in osteopetrosis should be treated by valgus subtrochanteric osteotomy – technically difficult– good result.

16. thank you