Proximal femoral osteotomies in children using the Richards hip screw: techniques, outcome and subsequent removal.

Introduction: We investigated the clinical and radiological outcome of proximal femoral osteotomies in children using the Richards hip screw. We also describe previously unreported techniques used in the insertion of the screw to aid satisfactory correction of the neck shaft angle and medialisation.

Methods: Seventy-two children undergoing 81 proximal femoral osteotomies under the care of the senior author over a 10-year period were reviewed.

Results: For the primary procedure, there was an overall complication rate of 5%. This included two (2.5%) cases requiring re-operation. There were no fractures and no long-term complications. For subsequent removal of the metalwork, the complication rate was 5%, with a re-operation rate of 1%.

Conclusion: We conclude that the Richards hip screw is a safe, atraumatic and easy-to-use method of fixation for proximal femoral osteotomies in children, with lower complication.