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Comparison between conservative and surgical treatment in Perthes disease
Atilla Cıtlak1, Servet Kerimoğlu, Celal Baki
1Department of Orthopaedics and Traumatology, Giresun University, School of Medicine, 28100 Giresun, Turkey. atillacitlak@yahoo.com
Introduction:
The purpose of this study was to compare the results of conservative and surgical treatment in a homogeneous group constituted by patients between 6 and 8 years of age at onset of the Perthes disease with Herring B involvement.
Methods:
Twenty-seven hips of 25 patients were evaluated radiologically and clinically. Patients were divided into two groups in terms of treatment type. In group I [16 hips of 14 patients], hips were treated conservatively using Thomas splints. The mean follow-up period was 21.5 (10-25) years. In group II [11 patients], hips were treated surgically using femoral osteotomy. The mean follow-up period was 14.3 (8-20) years.
Results:
There was no statistically significant difference between the groups in terms of Stulberg classification, but surgically treated patients had more varus angle, more shortening, and more trochanteric overgrowth compared with the braced group.
Conclusion:
Non-surgical treatment with a brace is a reliable alternative to surgical treatment in Perthes disease between 6 and 8 years of age at onset with Herring B involvement. However, we could not know whether the good results were influenced by the brace or stemmed from having good prognosis of these patients.