title: Arthrodiastasis and surgical containment in severe late-onset Perthes disease: an analysis of 14 patients.
abstract: Late-onset Perthes disease usually carries a poor prognosis. In severe cases there may be increasing pain, decreased range of motion and hinge abduction which forms a contraindication for surgical containment. We have managed 14 such patients in a two-stage procedure. Arthrodiastasis done as a first stage dramatically reduced pain and Trendelenburg limp while at the same time leading to a substantial improvement in range of motion and hinged abduction. Once the contraindications to surgical containment were overcome by arthrodiastasis, we proceeded with a varus osteotomy of the femur in a second stage in the hope that the femoral head would remodel to some extent with time and would improve the final functional outcome.
authors.affiliation: Department of Orthopaedics, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Pebam
authors.initials: P
authors.lastname: Sudesh
authors.forename: Kamal
authors.initials: K
authors.lastname: Bali
authors.forename: Aditya Krishna
authors.initials: AK
authors.lastname: Mootha
authors.forename: Mandeep Singh
authors.initials: MS
authors.lastname: Dhillon
authors.forename: Raghav
authors.initials: R
authors.lastname: Saini
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D005260:Female; D005269:Femur / Q000601:surgery; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000379:methods*; D010027:Osteotomy; D011859:Radiography