A prospective study of nonoperative and operative management for Perthes' disease

Area of Science:

• Pediatric Orthopedics
• Pediatric Rheumatology
• Pediatric Radiology

Background:

• Perthes disease affects the hip joint in children, leading to femoral head deformity.
• Treatment aims to maintain sphericity and prevent long-term complications.
• Predicting treatment outcomes is crucial for patient management.

Purpose of the Study:

• To compare treatment outcomes in children with Perthes disease based on referral source.
• To identify predictors of treatment success in Perthes disease.
• To evaluate the influence of age and femoral head shape on outcomes.

Main Methods:

• Two randomized groups of children with Perthes disease underwent bed rest and skin traction.
• Interventions included weight-relieving calipers or proximal femoral varus osteotomy.
• Arthrography assessed femoral head shape at presentation; Catterall grouping was also used.

Main Results:

• Similar outcomes were observed between the two treatment groups.
• Femoral head sphericity on arthrography was a better predictor than Catterall grouping.
• Child's age at treatment and femoral head sphericity were principal influences on outcome.

Conclusions:

• Treatment outcomes for Perthes disease are similar regardless of referral source when using bed rest, traction, and subsequent interventions.
• Femoral head shape and patient age are more significant predictors of outcome than Catterall classification.
• Walking speed post-treatment correlated with height, not healed femoral head shape in this age group.