In early cases of adolescent coxa vara, which show a backward and downward displacement of the head, an attempt should be made by forcible manipulation to separate the head from the neck. If this is successful, or if there has been an accidental fracture at the epiphyseal line, it is possible to secure an accurate alignment of the head with the neck, not by the Whitman procedure which has hitherto been employed (full extension combined with internal rotation and abduction of the thigh), but by internal rotation and abduction combined with flexion of the thigh at an angle corresponding to the degree of the posterior displacement of the head. The immobilization is also one of partial flexion (five to twenty-five degrees), wherein it differs from the Whitman position, which is one of full extension. This method of reduction and immobilization, based as it is on the accepted principles governing the treatment of all fractures, has given excellent results in the three cases reported in this paper.
(C) 1931 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.