Femoral Malalignment

An increased neck-shaft angle is referred to as coxa valga, while a decreased neck-shaft angle is termed coxa vara. If the femoral neck plane is excessively directed anteriorly, this is known as coxa antetorta; if the malalignment is directed posteriorly, it is termed coxa retrotorta. Axial malalignments can be congenital, unilateral, or bilateral. Furthermore, they can arise from metabolic disorders, malunited fractures, circulatory disturbances in childhood (Perthes’ disease), and slippage of the growth plate in childhood (slipped capital femoral epiphysis).

When is surgery needed?

Malalignment of the proximal femur leads not only to joint dysfunction but, more significantly, to abnormal loading of the hip joint. This can lead to premature degenerative changes in the hip joint. To prevent this, the malalignment can be surgically corrected.

What happens during surgery?

Following a precise analysis of the malalignment, the bone in the femoral region is either corrected for its deformity and fixed with a plate. The operation is performed under inpatient conditions.

Aftercare

Mobilisation begins on the first day after the operation with the aid of physiotherapy and forearm crutches. The operated joint/leg must not be fully weight-bearing for 3 to 6 weeks. During this period, temporary partial weight-bearing with forearm crutches must be observed. Medical thrombosis prophylaxis is required for this duration. After inpatient discharge, physiotherapy should be continued, possibly in the form of inpatient or outpatient rehabilitation. Typically, a rehabilitation period of 12 weeks can be expected after a femoral correction. Patients should anticipate a period of incapacity for work lasting 3 months.