Salter innominate osteotomy in the treatment of late presentation Perthes disease.
OBJECTIVE
The aim of this study was to evaluate the clinical and radiological results of patients presenting older than eight years and treated with Salter osteotomy for Perthes disease.


METHODS
Seventeen patients (18 hips) with late presentation of Perthes disease treated with Salter osteotomy. Sixteen males were identified. The average age of patients was 8.8 years (range 8-12). Preoperation radiographs were analysed for lateral pillar staging, centre-periphery (CP) angle, Sharp acetabular index, acetabular depth index, acetabular covering percentage and Cross-over sign. Final follow-up radiograph were classified using modified Stulberg grade.


RESULTS
The average follow-up of the patients was 78 months (range 40-104). During the surgery, seven hips were found to be lateral pillar grade B, three hips grade B/C and 8 hips grade C. In the final examination, 10 hips were evaluated as good (Stulberg 1 or 2), seven as medium (Stulberg 3) and one as bad (Stulberg 4). There was shortening in four patients who were all either Stulberg stage 3 or 4. A meaningful difference was detected between the pre-operation and post-operation radiographic values, regardless of the surgical staging. However, no statistical difference was found between the patients in Stulberg stage 3 or 4 and stage 1 or 2 for radiographic variables.


CONCLUSIONS
Salter osteotomy can be used to treat older patients with lateral pillar stage B, B/C and C at presentation.
1 Baltalimani Bone Diseases Training and Research Hospital, Istanbul - Turkey.
Umut
U
Yavuz
Bilal
B
Demir
Timur
T
Yildirim
Kubilay
K
Beng
Eyup Salahattin
ES
Karakas
D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods*; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome