Proximal Femoral Osteotomies in the Adolescence: Indications and Treatment Strategies.

Proximal femoral osteotomies are common surgical interventions to treat hip deformities in pediatric orthopedics. The aim of proximal femoral osteotomies is to optimise hip containment by using varus or valgus osteotomy, flexion or extension osteotomy with shortening, lengthening or derotation of the femoral neck. Furthermore improved muscular dysbalance by enhancing the femoral offset, extension of the range of motion and pain reduction are important surgical intentions. In the long term, a proximal femoral osteotomy is meant to minimize the probability of an early osteoarthritis of the hip. In the current literature many different types of proximal femoral osteotomies are described. They can be divided concerning their anatomical localization into subcapital, base of the femoral neck, intertrochanteric and subtrochanteric osteotomies. A profound knowledge about the deformity and the anatomical situation is essential to choose the appropriate osteotomy. The aim of this review is to show the different ways of proximal femoral osteotomies and their indications after having done a selective literature research. Furthermore over the last years the osteosynthesis materials have changed from blade plates (non-locking) to locking compression plates which allow an early re-mobilization without hip spica casts.