Operative versus conservative treatment of Calvé-Legg-Perthes disease

The results of treatment in two groups of patients with Calvé-Legg-Perthes disease are compared, one group having received conservative treatment consisting of bed rest and avoidance of weight-bearing, and the other operative treatment consisting of a subtrochanteric varus-rotational osteotomy without any restrictions of physical activity after healing of the osteotomy. In both groups the femoral head destruction was classified according to Catterall, and thus the operatively treated group on the whole had more seriously affected hips than the conservatively treated group. Although the main advantage of operative treatment is the short period of time spent in bed and the otherwise unrestricted physical activity, the results showed very little difference between the degree of femoral head congruity, the covering of the head by the acetabulum and the preservation of leg length and hip motility after operative as compared with conservative treatment. A retardation of skeletal maturity is present particularly in patients with bilateral affections.