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Valgus osteotomy: a solution for late presentation of hinge abduction in Legg-Calvé-Perthes disease
Graham J C Myers1, Keshav Mathur, John O'Hara
1Department of Paediatric Orthopedics, The Royal Orthopaedic Hospital, 31 Harts Green Road, Harborne, Birmingham, UK. gjcmyers@aol.com
Background:
This is a study to establish the role of surgery in late presenting hinge abduction following Legg-Calvé-Perthes disease.
Methods:
A prospective study was carried out involving 15 patients who underwent valgus femoral osteotomy for hinge abduction related to Perthes disease between 1995 and 2000. Surgery was performed by the senior author. There were 2 females and 13 males; in 6 cases, the left hip was affected, and in 9, the right. There were no cases of bilateral Perthes disease. The mean age at the time of surgery was 17 years and 9 months with an age range of 11 years to 32 years and 6 months. All patients were Stulberg grade 3 or 4 preoperatively.
Results:
The mean follow-up was 78 months (range, 61-95 months). The mean Harris hip score (HHS) preoperatively was 48 with a range of 29 to 75. At a mean of 22 months postoperatively, the HHS improved to a mean of 89 (range, 62-100) points (P < 0.01). There was no subsequent significant alteration in the HHS from the time of initial follow-up to final follow-up at 6.5 years.
Conclusion:
This study illustrates the role of valgus femoral osteotomy in patients presenting late with hinge abduction, demonstrating that the initially early improvement in patient function stabilizes and does not alter at 6 years.
Level Of Evidence:
Prospective study. Level 1.