Coxa Vara
Discovering that your child has coxa vara can be overwhelming. Our goal is to offer guidance to help you and your child through their coxa vara journey and provide support along the way.
On this page you will find:
- What is Coxa Vara?
- Why Does it Happen?
- How is Coxa Vara Detected?
- Treatment of Coxa Vara
- How Will Coxa Vara Affect My Child?
- Sharing the News
- Support
- Resources
What is Coxa Vara?
Coxa Vara is a rare condition of the hip, affecting around 1 in 25,000 children, in either hip, with boys or girls being equally affected.
To understand this condition, it helps to understand the shape of the thigh bone (femur). Most of the femur runs straight down the leg, while the top part angles inwards to meet the hip joint.
In children with coxa vara, the angle at which the femur meets the hip joint is smaller than usual, typically less than 120° whereas in other children, the angle is usually around 125°- 135°: This makes the leg appear shorter and can lead to a limp.
The condition can be present at birth (congenital), but this is uncommon. More often, it develops as a child grows and may not become noticeable until they are around two or three years old.
Why Does it Happen?
In most cases, it is not known why coxa vara happens.
When coxa vara is present at birth, it may sometimes occur alongside other conditions that affect bone or limb development, such as proximal focal femoral deficiency (PFFD) or fibular hemimelia.
How is Coxa Vara Detected?
Symptoms of coxa vara become apparent, typically between the ages of two and six (when the child is walking) and may include:
- pain in the leg and/or hip – (the condition can also be painless)
- a one-sided limp or ‘waddling walk’ that gets progressively worse
- stiffness when trying to move the leg out to the side – for instance, into a ‘frog-like’ position
- a slight difference in leg length
Diagnosis is usually made using X-rays.
Treatment of Coxa Vara
Mild cases may require no treatment and follow up checks may be arranged to monitor the hip as it grows.
In more severe cases, surgery may be recommended to improve the hip joint by shaping the bone (osteotomy).
Following hip surgery, a child may require some time in a ‘hip spica’ cast. Steps have produced Hip Surgery and Spica Cast Care, a Parent’s Guide which has useful information on what to expect and how to look after a child in a hip spica cast. Steps have also created a Hip Spica Cast Equipment list, based on suggestions from parents, for suitable equipment, such as car seats and buggies, that can be used while your child is using a hip spica cast.
The timing of surgery will depend on the age at which the child is diagnosed, the severity of the condition and can differ between treatment centres. If a child is diagnosed very young when the hip is still developing, surgery may be delayed until they are five or six, especially if the condition is mild or the child is managing well. In other cases, a child may undergo surgery at around 18 months, however this decision will depend on their individual circumstances.
How Will Coxa Vara Affect My Child?
Mild and successfully treated cases will have little impact on a child into adulthood. However, if coxa vara is left undiagnosed/untreated, it may lead to problems with walking in later life and will increase the risk of osteoarthritis.
Sharing the News
When and how you tell close family, friends and other relatives about your child’s condition is a very personal decision which will be impacted by how and when the diagnosis occurred, the individual prognosis for your child and the potential treatments available.
There is no right or wrong way or time to share the news; however, being well informed about the condition and having the opportunity to connect with other parents who can understand what you are feeling will likely help.
Once you do share the news, your relatives and friends will probably want to know how they can support you and your child, so take advantage of the experiences being shared by other parents, to help you feel equipped to answer such questions and get the support that is right for you.
Support
Steps is here to offer emotional and practical support.
The Steps closed Facebook Group is a friendly and safe way of discussing your worries, sharing tips and finding emotional support. Our Family Contact Service identifies someone else who has been through a similar situation and who’s happy to talk about their experiences, on a one-to-one basis, to offer support.
You can reach out to Steps with your questions, concerns and requests via email info@steps-charity.org.uk or leave a voicemail message on 01925 750271 and one of the team will be in touch.
All our coxa vara links and related resources can be found below
