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Innominate osteotomy in Perthes disease
H J Robinson1, H Putter, M B Sigmond
1Department of Orthopaedic Surgery, University of Minnesota Hospitals and Clinics, Minneapolis 55455.
Insights
Innominate osteotomy effectively treated severe Perthes disease in children, yielding good or fair clinical outcomes in 88% of cases. This surgical approach demonstrated positive results even with significant femoral head deformity.
Area of Science:
- Orthopedic Surgery
- Pediatric Orthopedics
- Hip Preservation Surgery
Background:
- Perthes disease, a childhood hip disorder, can lead to significant femoral head deformity and long-term disability.
- Innominate osteotomy is a surgical technique used to treat severe Perthes disease.
- Previous studies have reported varying outcomes for this procedure.
Purpose of the Study:
- To evaluate the long-term clinical outcomes of innominate osteotomy in patients with severe Perthes disease.
- To assess the efficacy of innominate osteotomy in improving hip function and morphology.
Main Methods:
- A retrospective study of 27 patients who underwent innominate osteotomy for severe Perthes disease.
- Analysis of clinical outcomes, including range of motion and pain.
- Assessment of radiographic parameters and femoral head morphology.
- Follow-up duration ranged from 5 years to over 16 years.
Main Results:
- 88% of patients achieved clinically good or fair results.
- 12% of patients had poor results.
- The study included patients with significant femoral head deformity.
- A notable proportion of patients were under 6 years old at disease onset.
Conclusions:
- Innominate osteotomy is an effective treatment for severe Perthes disease, even in cases with significant femoral head deformity.
- The procedure can lead to favorable long-term clinical outcomes in a majority of pediatric patients.
- Treatment durations, including preoperative and postoperative phases, may exceed those previously reported.
Abstract:
A retrospective study was performed in 27 patients who underwent innominate osteotomy for the treatment of severe Perthes disease. Time intervals between surgery and final follow-up ranged from 5 years to 16 years 4 months. Preoperative and postoperative periods of treatment were often more prolonged than those reported by Salter. One-half of the patients were less than 6 years of age at onset of the disease. A number of patients had significant deformity of the femoral head. Nevertheless, clinically good or fair results were obtained in 88% of the patients and poor results were found in 12%.