Coxa vara

Coxa vara is a deformity of the hip where the angle formed between the head and neck of the femur and its shaft is decreased, typically below 120-135 degrees. This condition can lead to a variety of complications, including reduced hip movement, limping, and the development of osteoarthritis in the hip joint. Coxa vara can be congenital, meaning present at birth, or acquired due to other conditions such as developmental dysplasia of the hip, Perthes disease, or following a fracture.

Causes

Coxa vara can arise from several different causes, which are generally classified into three main categories:

• Congenital Coxa Vara: Present at birth, this form is often associated with other skeletal abnormalities.
• Developmental Coxa Vara: This form develops during childhood, even if not present at birth. It is often linked with conditions like Developmental Dysplasia of the Hip and Perthes Disease.
• Acquired Coxa Vara: This can occur as a result of a fracture in the hip area, infection, or other diseases affecting the bone such as osteomalacia or rickets.

Symptoms

The symptoms of coxa vara may vary depending on the severity of the condition but commonly include:

• Limping or changes in gait
• Reduced range of motion in the hip
• Leg length discrepancy
• Muscle weakness around the hip
• Pain in the hip or knee

Diagnosis

Diagnosis of coxa vara typically involves a combination of physical examination and imaging studies. During the physical exam, the doctor will look for signs of hip deformity, leg length discrepancy, and limited range of motion. Imaging tests such as X-rays and MRI scans are used to confirm the diagnosis and assess the severity of the deformity.

Treatment

Treatment for coxa vara depends on the age of the patient, the cause, and the severity of the deformity. Options include:

• Non-surgical Treatment: In mild cases, especially in children, treatment may involve observation and follow-up, physical therapy to strengthen the muscles around the hip, and braces or casts to correct the deformity.
• Surgical Treatment: Surgery may be recommended for severe cases or when non-surgical treatment fails to improve symptoms. Surgical options include osteotomy, where the bone is cut and realigned, and fixation, where the bone is stabilized with screws, plates, or rods.

Prognosis

The prognosis for individuals with coxa vara varies depending on the underlying cause and the severity of the deformity at the time of diagnosis. Early detection and treatment can improve the outcome, reducing the risk of complications such as osteoarthritis and improving hip function.

See Also

• Hip Dysplasia
• Osteotomy
• Perthes Disease