# 5. Coxa vara. Coxa valga. Epiphysiolysis adolescentia.

Question 1

What is Coxa VARA?

Answer 1

• A Congenital Disease, of the hip
• Characterised by REDUCED Neck-Diaphyseal Angle, UNDER 120D
• “Neck-Diaphyseal Angle” =The Angle BTW the Head + Femur Shaft

Question 2

What are the Changes in the Neck-Diaphyseal Angles?

Answer 2

1) ** Birth** = 137 D

2) ** Beginning of 2nd Year** = 144 D

3) ** Adolescence** = 126 D

3) ** Adults** = 120 -125 D

Question 3

What are the CLINICAL FEATURES of Cox VARA?

Answer 3

• 1st Symptoms appear AFTER Children learn to walk
• HARDENING / PAIN of the Joints
• Children REMAIN SHORTER

Question 4

What does the X-RAY Imaging show in Coxa VARA?

Answer 4

• Neck-Diaphyseal Angle UNDER 120 D
• Shorter / Fragmented Neck
• Bony Triangular Filament at Bottom of Neck that’s ATTACHED to the Head
• Acetabulum DEFORMATION

Question 5

What is the TREATMENT for Coxa VARA?

Answer 5

• RESTORATION of the Neck-Diaphyseal Angle
• NORMALISE the GAIT
• Cure the POSITIVE Trendelenburg Symptom
• Surgery = Valgus OSTEOTOMY

Question 6

What is Coxa VALGA?

Answer 6

• INCREASED Neck-Diaphyseal Angle, MORE than 140 -150 D
• Presenting with Congenital LUXATIO of PELVIC Joint with a INCREASED Anteversion

Question 7

What are the CLINICAL FEATURES of Coxa VALGA?

Answer 7

• Child starts to limp and gets tired
• feels pain if joint is under pressure
• X-Ray confirms diagnosis

Question 8

What’s the TREATMENT OPTION for Coxa VALGA?

Answer 8

• Varus OSTEOTOMY

Question 9

What is EPIPSISIOLYSIS ADOLESCENTIA?

Answer 9

• A deformation that occurs in children when they grow up
• DUE to = Rickets / Osteomalacia / Endocrine Disorders / Trauma / Obsesity
• Presenting with UNDER-DEVELOPED External Primary / Secondary Sexual Characteristics

Question 10

What are the CLINICAL FEATURES of EPIPHYSIOLYSIS ADOLESCENTIA?

Answer 10

• Easily tired
• Light pain to the hip joint
• Limping
• Difficulty with Abduction

Question 11

What does X-RAY Imaging Show for EPIPHYSIOLYSIS ADOLESCENTIA?

Answer 11

• Sliding / Rotation of the Epiphysis, around Axis of Neck

Question 12

What is the TREATMENT for EPIPHYSIOLYSIS ADOLESCENTIA?

Answer 12

• Treat the underlying cause of SLIDING
• Vitamin D = For RICKETS
• For Endocrine Disorders = Give Hormones

Surgery

• Put Epiphysis back into position with KIERSCHNER NEEDLES
• Neck OSTEOTOMY

Question 13

What are the COMPLICATIONS of EPIPHYSIOLYSIS ADOLESCENTIA?

Answer 13

• AVASCULAR Necrosis
• PERTESO-like-changes of the Head
• Joint Contractures