Guided Growth Improves Coxa Valga and Hip Subluxation in Children with Hereditary Multiple Exostoses

Tun Yu Hung, Kuan Wen Wu, Chia Che Lee, Sheng Chieh Lin, Ken N. Kuo, Ting Ming Wang

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: In children with severe hereditary multiple exostoses (HME), coxa valga, and hip subluxation are common deformities. The literatures related to surgical management and prevention of hip joint subluxation in HME are scarce. In this study, we aimed to investigate the efficacy of guided growth procedure to correct coxa valga and hip subluxation in HME patients. Methods: We retrospectively retrieved 12 patients who received guided growth procedures for coxa valga and hip subluxation in HME patients with proximal femur exostoses with a minimum follow-up time of 2 years between 2012 and 2019. Radiographic parameters include head-shaft angle, Hilgenreiner-epiphyseal angle, acetabular index, Reimer migration percentage, center-edged angle, articulo-trochanteric distance, and femoral neck length for comparison between preoperative and latest follow-up results. It was conducted statistically by paired t test and Wilcoxon signed rank test. Results: In this study, the mean difference between preoperative and latest follow-up was significant in head-shaft angle (12±5 degrees; CI, 10-14; P<0.001), Hilgenreiner-epiphyseal angle (12±5 degrees; CI, 10-15; P<0.001), and MP (7%±8%; CI, 3-11; P=0.001). There was a low revision rate (4 of 21, 19%) and no complication in our study. Compared with previous studies on guided growth in children with cerebral palsy and developmental dysplasia of the hip, our study showed good comparable outcomes. Conclusion: The results indicated that guided growth improves the hip radiographic parameters of children with HME and may prevent coxa valga and hip subluxations. It is a safe procedure and provides predictable results. Level of Evidence: Level IV; therapeutic, case series.

Original languageEnglish
Pages (from-to)E67-E73
JournalJournal of Pediatric Orthopaedics
Issue number1
Publication statusPublished - Jan 2023


  • coxa valga
  • guided growth
  • hereditary multiple exostoses
  • hip subluxation
  • pediatric orthopaedics

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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