Van Nes rotational osteotomy for treatment of proximal femoral focal deficiency and congenital short femur.

The results of twenty Van Nes rotational osteotomies for unilateral proximal femoral focal deficiency and congenital short femur were analyzed after follow-ups of two to eight years. Assessed on the basis of prosthetic function, the results were good in ten, fair in six, and poor in four. Twelve patients required a rerotation procedure, six of them twice, because of postoperative derotation. Appropriate leg-length discrepancy to place the ankle, converted to the knee, at the right level, as well as normal ankle and foot motion and muscle power, are prerequisites to the procedure, which should be deferred until the child is about twelve years old to avoid prolonged hospitalization for rerotation and gait training.