Corrective osteotomy for treatment of symptomatic femoral deformities

Femoral deformities can represent possible prearthrotic deformities due to incorrect loading of the hip joint. This can result in chronic and sometimes immobilizing discomfort up to early coxarthrosis and the necessity for hip joint replacement at a young age. Therefore, with symptomatic femoral deformities early treatment is of decisive importance to prevent further damage. As symptomatic femoral deformities can have very different causes, analysis of the individual cause is important for correct treatment planning and detection of accompanying pathologies. A certain differentiation of the following entities is crucial: a tapering disorder at the anterolateral femoral neck in cases of cam femoroacetabular impingement (FAI), residual deformity after Perthes disease or epiphyseolysis of the femoral head (ECF), rotation deformity (femoral anteversion/retroversion) and misalignment (femoral varus/valgus deformity), which can lead to intra-articular and/or extra-articular impingement. Possible treatment options are various forms of corrective osteotomy with plate osteosynthesis and intramedullary nailing as well as supporting hip arthroscopic or mini-open techniques. The common goal should be correction of the underlying pathology and to address the subsequent individual damage to eliminate current complaints as well as to ensure long-term survival of the native hip joint.