Anteromedial Wedge Reduction Osteotomy for the Treatment of Femoral Head Deformities

Abstract

Aspherical femoral head deformity has poor a prognosis which can lead to early arthritic changes in young adults. The intraartricular anteromedial wedge reduction osteotomy restores sphericity of the femoral head. We performed seven anteromedial wedge reduction osteotomies. Clinical indications were pain, limp and restriction of movement of the hip joint. The mean age at time of the surgery was 13.3 years. The aetiology of the femroal head deformity was Perthes disease in six patients and in one patient, multiple epiphyseal dysplasia. All seven hips were classified as Stulberg V before surgery. At a mean follow-up of 17.4 months the Harris hip score increased from a mean of 55.4 pre-operatively to a mean of 84.8 postoperatively. The final results were Stulberg IV in one hip, Stulberg III in four hips and Stulberg II in two hips postoperatively. The capital diaphyseal ratio dropped from average of 1.57 pre-operatively to 1.21 postoperatively. No signs of osteonecrosis were recorded. One patient suffered a subluxation of the femoral head. The anteromedial wedge reduction osteotomy has good short-term results in aspherical incongruent hips.