Management of Perthes disease of late onset in southern India. The evaluation of a surgical method.
We analysed the short-term outcome after varus osteotomy for Perthes' disease in 48 older children from south-west India, comparing them with 30 historical controls. The children were between 7 and 12 years of age at the onset of the disease. All had stage-I or stage-II disease, with half or more of the epiphysis involved. The operated children had an open-wedge subtrochanteric varus osteotomy with derotation or extension and a trochanteric epiphyseodesis. Weight-bearing was avoided until late stage III. The non-operated children had been treated symptomatically by conservative methods. At the time of healing, 62.5% of the operated group had spherical femoral heads compared with 20% of those treated non-operatively (p < 0.001). Of the operated children with Catterall group-IV involvement, 48% had good results as against 24% of the non-operated group (p < 0.05). The percentage increase in the radius of the affected femoral head compared with the normal side was significantly lower in children who had operations (14.68 v 25.65; p < 0.001). We have shown that the short-term results of early surgical containment in children over seven years of age are satisfactory.
Joseph
B
B
Kastruba Medical College, Manipal, India.
Srinivas
G
G
Thomas
R
R
D001860:Bone Plates; D001863:Bone Screws; D002648:Child; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007194:India; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods / Q000706:statistics & numerical data; D011859:Radiography; D014143:Traction; D016896:Treatment Outcome