Congenital Coxa Vara Clinical Presentation

Updated: Feb 03, 2016
  • Author: Ken K Kontio, MD, FRCSC; Chief Editor: Jeffrey D Thomson, MD  more...
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Presentation

History and Physical Examination

Patients with congenital coxa vara (CCV) usually present with gait abnormalities. Affected children generally present between the time they begin ambulation and age 6 years.

In most patients, the gait abnormality is progressive and, notably, pain free. Unilateral involvement with an associated relative limb-length discrepancy and Trendelenburg limp may be noted. This discrepancy in limb lengths usually is mild, ranging from 1.5 to 4.0 cm. Patients with bilateral involvement commonly present with a waddling gait abnormality, similar to that of patients with bilateral developmental dysplasia of the hip (DDH). The Trendelenburg sign is commonly elicited in the affected hip or hips.

A tabletop examination may reveal weak abductors, a prominent greater trochanter, decreased abduction due to a decreased articulo-trochanteric distance, and coxa vara. A decrease in internal rotation also is often noted, caused by decreased femoral anteversion or true retroversion associated with this condition.