engleski

Femoral varus derotational osteotomy in treatment of Legg-Calve-Perthes disease - Radiological study of cases operated during 20 years period.

Purpose: To present results of femoral varus derotation osteotomy for Legg-Calve-Perthes disease done in our department over period of 20 years. Methods: Retrospective analysis of medical records of 57 hips (57 patients, 51 males, 6 female) operated using femoral varus derotation osteotomy. Mean age at the time of operation was 7 years. Mean follow up was 82 months. We analysed preoperative and postoperative x-rays. We used Herring classification, Catterall classification preoperatively. Immediately after operation and at final follow up we analysed: neck-shaft angle, articulo- trochanteric distance, CE-angle of Wiberg and head coverage. Finally, we used Stulberg classification to evaluate our results. Results: According to Herring classification 8 type A, 24 type B and 24 type C and one type B7C hips were operated on. Using Catterall classification there were 8 type 1, 15 type 2, 22 type 3 and 12 type 4 hips. Head coverage was improved significantly in all cases. At final follow up we had 19 Stulberg type 1 hips (33%), 18 type 2 hips (32%), 16 type 3 hips (30%) and 4 type 4 hips (5%). Eight patients needed additional surgery: apophyseodesis of the great trochanter in two patients, Shelf acetabuloplasty in two patients, greater trochanter transfer (distalisation) in two patients and combined procedures in two patients. Conclusion: When comparing our results with other studies results are comparable. During last 30 years indications for operative procedures in Legg-Calve-Perthes disease has been changed significantly. When we look at our results in the light of today's knowledge we see that many good results we achieved were due to the fact that those children would did good without surgery, probably. On the other hand severe cases with extensive head involvement will result with poor mechanics of the hip joint when using femoral osteotomy alone, thus additional procedures are required.

femoral varus derotational osteotomy ; Legg-Calve-Perthes disease ; radiological study

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