Clinical Outcomes of Open-Wedge Varus Derotation Osteotomy in Legg-Calve-Perthes Disease Among 6-12-Year-Old Children

Background Legg-Calve-Perthes (LCP) disease during early childhood might lead to impaired blood circulation to the femoral head causing osteoarthritis and avascular necrosis of the femoral head. In most cases of children diagnosed after the age of nine years, the progression of LCP disease is associated with poor outcomes causing disability. This study aimed to evaluate the clinical and radiological outcomes of varus derotation osteotomy in children with LCD disease with a late presentation at 6-12 years of age. Methodology This prospective study was performed among 25 6-12-year-old children who were diagnosed with LCD disease. Children were classified per Herring's Lateral Pillar and Catterall classification. They were treated with open-wedge varus derotation osteotomy, and clinical, radiological, and functional parameters were assessed postoperatively. The postoperative grading was done using the Catterall classification. Results In this study, significant improvement in the postoperative mean Harris Hip Score (82.96 ± 4.3 vs. 85.36 ± 3.75; p = 0.000) was observed. In addition, the mean muscle mass reduced postoperatively compared to the preoperative mass (2.64 ± 3.82 vs. 8.52 ± 3.73 mm; p = 0.000). Based on the Catterall classification, 56% of children showed good outcomes, and 36% showed fair outcomes. Regarding complications, 20% had postoperative infections. Conclusions In our study, open-wedge varus derotation osteotomy showed improved clinical and radiological outcomes in children with late presentation of LCD disease.