Coxa vara

Coxa Vara

Diagram showing the angles of the femur, including coxa vara.

Coxa vara is a deformity of the hip joint where the angle between the head and the shaft of the femur is reduced to less than 120 degrees. This condition can lead to a variety of clinical symptoms and complications, affecting the biomechanics of the hip and lower limb.

Anatomy and Pathophysiology

In a normal hip joint, the angle between the head and the shaft of the femur, known as the femoral neck angle, is typically between 120 and 135 degrees. In coxa vara, this angle is decreased, which can alter the distribution of weight and stress across the hip joint.

The reduction in the femoral neck angle can lead to:

• Increased stress on the femoral neck, predisposing it to fractures.
• Altered gait patterns due to changes in biomechanics.
• Potential development of osteoarthritis due to abnormal joint loading.

Causes

Coxa vara can be congenital, developmental, or acquired. Some common causes include:

• Congenital coxa vara: Present at birth, often due to developmental abnormalities.
• Developmental coxa vara: Occurs during childhood as the bones grow.
• Acquired coxa vara: Can result from conditions such as rickets, osteomalacia, or trauma to the hip.

Clinical Presentation

Patients with coxa vara may present with:

• Limping or altered gait.
• Hip pain or discomfort, especially with activity.
• Limited range of motion in the hip joint.
• Leg length discrepancy, with the affected leg appearing shorter.

Diagnosis

Diagnosis of coxa vara is typically made through clinical examination and confirmed with imaging studies such as X-rays. The X-ray will show a decreased femoral neck angle, and additional imaging may be used to assess the extent of the deformity and any associated conditions.

Treatment

Treatment of coxa vara depends on the severity of the deformity and the symptoms experienced by the patient. Options include:

• Conservative management: Physical therapy and activity modification for mild cases.
• Surgical intervention: Osteotomy procedures to correct the angle of the femur in more severe cases.

Prognosis

The prognosis for individuals with coxa vara varies depending on the underlying cause and the effectiveness of treatment. Early intervention can improve outcomes and reduce the risk of complications such as osteoarthritis.

Related Pages

• Hip dysplasia
• Femoral neck fracture
• Osteotomy