Femoral Osteotomy — Proximal Femoral Varus Derotational Osteotomy (VDRO)

Children's Colorado / Center for Gait and Movement Analysis (CGMA) · CGMA Physical Therapy Team, Children's Colorado

Weight-Bearing

NWB x 6 weeks in double hip spica cast; WB status after cast removal determined by MD based on bone density/healing/x-ray findings

Key Restrictions

No impact, torque, or unprotected WB x 6 weeks; minimize fall risk; spasticity may increase spasms/discomfort on cast removal; bivalved cast helpful for transition; osteopenic children require special care; WB progression guided entirely by MD and radiograph findings

Timeline & Phases

Phase 1 (days 1-7): NWB, pain management (ice/heat/massage/e-stim), safe transfers/mobility, PROM/AAROM knees/ankles, isometrics; Phase 2 (days 8-21): pain management, independence with transfers/ADLs; Phase 3 (days 22-42): avoid impact/torque, bracing re-evaluation at week 6 per MD; Phase 4 (week 7+): full LE ROM/AROM, bracing for gait, total LE strengthening, functional balance, scar mobility, return to pre-op function

Notes

Pediatric; indication is hip subluxation or dislocation; varus/derotation/shortening osteotomy at intertrochanteric region with plate fixation; iliopsoas released from lesser trochanter; Children's Colorado CGMA

Surgeon / Author

CGMA Physical Therapy Team, Children's Colorado

Published

October 2007