Management of Congenital Coxa Vara

Coxa vara includes all forms of decrease of the femoral neck shaft angle to less than 120-135°. This condition has many causes including: congenital, acquired, and developmental.By definition CCV, presents at birth but manifests clinically during early childhood and commonly follows a clinical course that is progressive with growth.CCV has a characteristic clinical and radiographic features that help to differentiate it from other forms of coxa vara. It is commonly associated with a significant limb-length discrepancy, segmental shortening of the femur or other abnormalities of the bony femur, differential diagnosis includes proximal femoral focal deficiency.Histologic investigations showed abnormalities in the proximal femoral physeal chondrocyte maturation, with disruption of the normal columnar architecture and abnormal calcification of the cartilaginous matrix. This resulted in decreased production of metaphyseal bone, leading to a relative osteoporosis and subsequent weaknessin this area.The treatment of choice either subtrochanteric or intertrochanteric osteotomy. Valgus proximal femoral osteotomy has been practiced by many authors and is the gold standard surgical treatment of congenital coxa vara. Fixation of the osteotomy has been achieved by various methods including external fixation, internal fixation with pins and cerclage and a variety of plates.