Age at onset, extent of necrosis, and containment in Perthes disease. Results at maturity.
BACKGROUND
The concept of containment of the femoral head within the acetabulum has been popularised as a principle of treatment in Perthes disease. The results of 30 patients treated for Perthes disease following a predefined scheme based on the containment were analyzed.


METHODS
All children were treated with abduction braces as long as containment was maintained. However, 15 of them required surgery due to failure of containment in the further course of the disease. All children were followed until skeletal maturity.


RESULTS
Within a mean follow-up period of 8 years and 9 months (range 5-13 years), all patients showed good clinical function. On radiographic assessment, 70% of the hips were Stulberg classes I and II, with a good prognosis.


CONCLUSIONS
Failure of the containment was influenced by age at onset and extent of necrosis. Weight-bearing abduction braces cannot be recommended in children who are 6 years and older and show femoral head involvement of more than 50%.
Roposch
Andreas
A
Department of Pediatric Orthopaedic Surgery, Karl Franzens University, Graz, Austria.
Mayr
Johannes
J
Linhart
WolfgangB E
WE
D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000000981:diagnostic imaging; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D011859:Radiography; D016896:Treatment Outcome