Module 19, Pediatric Orthopaedist Level

1, 2, 3

This 12 year old girl sustained a right femoral neck fracture by falling from a balcony(image 1). After 2 weeks of bed-rest, she was started walking with crutches. She completely returned to normal activities 6 months after the trauma. She was beginning to complain of the right hip pain 2 years after the trauma(image 2 & 3).

Question 19A

The large posterior surface of the femoral head remained intact therefore a base of the femoral neck osteotomy could be performed to rotate the femoral head forward and into valgus.

Question 19B

The Sugioka osteotomy is an easy procedure and would be the ideal to get the needed intact surface of the femoral head into the acetabulum.

Question 19C

The best planning studies to determine how the femur should be rotated involve getting a CT scan with three dimensional reconstruction.

Question 19D

The post-operative care of the Sugioka osteotomy requires three months in a spica cast.

Question 19E

Sugioka osteotomy is not recommended for very obese patients.