title: Treatment of the collapsed femoral head by containment in Legg-Calve-Perthes disease.
abstract: One hundred ninety-seven patients with unilateral Legg-Calve-Perthes disease (LCPD) were followed-up to skeletal maturity. According to the lateral pillar classification, 142 hips were classified as group B and 55 hips as group C. Radiographs were evaluated for percent of collapse of the femoral head, Waldenstrom stage of disease at diagnosis, Mose sphericity, hinge abduction, lateral acetabular shape, and limb-length discrepancy. The hips were treated either by bedrest and traction in abduction (76), Petrie cast (21), abduction brace (74), or by pelvic or femoral osteotomy (26). One hundred twenty-five hips had less than a 2-mm difference in Mose sphericity at followup. According to the classification of Stulberg et al., 89 hips (45%) were class I, 57 (29%) were class II, 35 (18%) were class III, 12 (6%) were class IV, and 4 (2%) were class V. Analyses revealed statistically significant differences between group B versus group C with regard to the classifications of Stulberg et al. and Mose, lateral acetabular shape, age at onset, and limb-length discrepancy. There was no significant statistical difference with regard to the types of treatment. Containment treatment of a deformed femoral head from LCPD improves the sphericity of the hip and gives 63% satisfactory results according to the Mose classification and 74% satisfactory results according to the Stulberg et al. classification.
authors.affiliation: Alfred I. duPont Hospital for Children, Wilmington, Delaware, USA.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Grzegorzewski
authors.forename: J Richard
authors.initials: JR
authors.lastname: Bowen
authors.forename: James T
authors.initials: JT
authors.lastname: Guille
authors.forename: Joseph
authors.initials: J
authors.lastname: Glutting
mesh_terms: D017677:Age Distribution; D000704:Analysis of Variance; D001510:Bed Rest; D001915:Braces; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005270:Femur Head / Q000503:physiopathology*; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016916:Joint Deformities, Acquired / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000209:etiology*; D007873:Legg-Calve-Perthes Disease / Q000145:classification* / Q000150:complications / Q000628:therapy*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy / Q000379:methods; D010147:Pain Measurement; D011336:Probability; D011859:Radiography; D016059:Range of Motion, Articular; D012042:Registries; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D018709:Statistics, Nonparametric; D013997:Time Factors; D014143:Traction / Q000379:methods; D016896:Treatment Outcome