Salter osteotomy in Perthes' disease. Late radiological results

Background. Surgical treatment in Perthes' disease has been used for many years, but the choice of operation method still remains controversial. The aim of this work is to analyze long-term radiological results at patients after Perthes' disease treated by Salter osteotomy. Material and methods. 113 hips were analyzed at 110 patients. Males were 90, females 20. Due to severity of changes in hips, patients were divided into groups according to Catterall: group II - 25 hips (22.1%), group III - 14 hips (12.4%), group IV - 74 hips (65.5%). Average patient's age at the time of surgery was 7.2 years. Follow-up time was 9 years (5-14years). Salter osteotomy was performed as described by its author. The material was analyzed according to age of disease onset, extensiveness of necrosis (Catterall classification), and the length of follow-up period. Radiographs taken before surgery and during last examination were evaluated. For results estimation, Mose criteria and Stulberg classification were applied. Results. According to Mose criteria, 63 hips (55.3%) had good result, 25 (21.9%) - fair and 25 hips (21.9%) - bad result. Using Stulberg classification, group I included 55 hips (49.4%), group II - 33 hips (29.1%), group III - 14 hips (12.3%), group IV - 8 hips (7.8%), group V - 2 hips (1.5%). Radiological parameters of head coverage improved after surgery. Arthrotic changes were noted in 8 hips (7.8%). Conclusion. Salter osteotomy assures good head coverage by the acetabulum and creates favorable conditions for spherical head reconstruction. Results after Salter osteotomy are permanent and do not depend on the length of follow-up period.