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Medial displacement Chiari salvage osteotomy
1%
18/1690
Proximal femoral varus osteotomy
4%
71/1690
Flexion, internal rotation, and valgus-producing proximal femoral osteotomy (Imhauser osteotomy)
71%
1202/1690
Bernese periacetabular osteotomy with extension, external rotation, and valgus-producing femoral osteotomy
6%
102/1690
Valgus-producing intertrochanteric proximal femoral osteotomy (Pauwel osteotomy)
17%
285/1690
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The Imhauser osteotomy (as shown in Illustration A) is described to correct the deformity often seen in the late treatment of SCFE. The osteotomy produces flexion, internal rotation and valgus (as shown in Illustration B). This correction is obtained via an anterior-based closing wedge osteotomy, rotating the distal fragment internally, and utilizing the blade plate to create valgus. Valgus correction can be incorporated into the osteotomy to correct the medial displacement of the epiphysis. The osteotomy was designed to correct the retroversion deformity, improve hip motion and mechanics, and decrease the incidence of osteoarthritis. The retroversion deformity seen in late SCFE may cause anterior femoroacetabular impingement through a cam type mechanism, which may contribute to the early development of osteoarthritis. Kuzyk et al present level 5 evidence stating that surgical hip dislocation is another option for post-SCFE hip impingement, and severe cases with a high epiphyseal-shaft angle may require both dislocation and intertrochanteric osteotomy.
3.6
(38)
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