Related Experiment Videos
Femoral osteotomy in Perthes' disease. Results at maturity
C J Coates1, J M Paterson, K R Woods
1Royal National Orthopaedic Hospital, London, England.
Insights
Upper femoral osteotomy is a recognized treatment for Perthes
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Pediatric bone diseases
Background:
- Perthes' disease affects the hip joint in children, primarily impacting the femoral head.
- Upper femoral osteotomy is a surgical option for specific cases of Perthes' disease, aiming to improve hip joint congruency and prognosis.
Purpose of the Study:
- To evaluate the long-term outcomes of upper femoral osteotomy in patients with Perthes' disease.
- To assess clinical function and radiographic results at skeletal maturity following the surgical procedure.
Main Methods:
- A cohort of 44 patients (48 hips) with Catterall group II, III, and IV Perthes' disease and 'head-at-risk' signs underwent upper femoral osteotomy.
- Clinical assessment included Harris and Iowa scores.
- Radiographic evaluation involved Stulberg classification, Catterall grading, and measurement of relevant indices.
Main Results:
- The study reported excellent clinical function post-surgery.
- A significant percentage of hips experienced shortening (29%) and a positive Trendelenburg's sign (25%).
- Radiographically, 58% of hips were classified as Stulberg class I or II, indicating a good prognosis.
Conclusions:
- Upper femoral osteotomy demonstrated positive outcomes for selected Perthes' disease patients, achieving good clinical function and radiographic results.
- The procedure showed better results compared to conservative treatment across most age groups, except for children under five years old.
Abstract:
Upper femoral osteotomy is a recognised treatment for selected patients with Perthes' disease. The results of this procedure were investigated at skeletal maturity in 44 patients (48 hips). The indication for operation was Catterall group II, III, and IV hips with 'head-at-risk' signs. Harris and Iowa scores were calculated clinically, and each hip was assigned radiographically to one of the five Stulberg classes, its initial Catterall grading checked and other relevant indices measured. Results showed excellent clinical function. Shortening was present in 14 hips (29%) and a positive Trendelenburg's sign was seen in 12 (25%). On radiographic assessment 58% of hips were Stulberg class I or II, with a good prognosis. The results of femoral osteotomy were better than those for conservatively treated hips in all age groups except those under five years.