title: Tönnis triple pelvic osteotomy for Legg-Calve-Perthes disease.
abstract: OBJECTIVE
  The aim of this study is to evaluate the efficacy of Tönnis triple pelvic osteotomy in patients with LCP disease.
  
  
  METHODS
  Between 2007 and 2011, Tönnis triple pelvic osteotomy was performed for 43 patients with LCP, in our institute. During the follow-ups of patients with LCP the indications for the surgery were lateralization of the femoral head, insufficient femoral head coverage and subluxation of the femoral head. The mean age of patients at the time of surgery was 9.4 years.
  
  
  RESULTS
  Before surgical intervention, according to Waldenstrom classification, three patients were in the necrosis stage (7 %), six patients in the fragmentation stage (13.9 %), 16 patients in the re-ossification stage (37.2 %) and 18 patients in the remodeling stage (41.9 %). According to Herring classification, four patients were in group B (9.3 %), one patient in group B/C (2.3 %) and 38 patients in group C (88.4 %). After the operation, patients were evaluated with Stulberg classification, and good outcome (Stulberg I/II) was achieved in 23 patients (53, 5 %), fair outcome (Stulberg III) in 16 patients (37, 2 %) and poor outcome (Stulberg IV/V) was seen in only four patients (9.3 %). The mean value of CEA was 0.37° pre-operatively and in the last follow-ups the mean value of CEA was 23.7°.
  
  
  CONCLUSIONS
  We recommend triple pelvic osteotomy for patients with LCP when conservative methods are not successful. According to our results we believe that Waldenstrom classification is a better option than Herring classification to determine the prognosis of disease after containment surgery.
authors.affiliation: Devrek State Hospital, Vedat Ali Özkan Cad, 67800, Devrek, Zonguldak, Turkey, yalkin.camurcu@gmail.com.
authors.forename: Ismet Yalkin
authors.initials: IY
authors.lastname: Camurcu
authors.forename: Timur
authors.initials: T
authors.lastname: Yildirim
authors.forename: Abdul Fettah
authors.initials: AF
authors.lastname: Buyuk
authors.forename: Sukru Sarper
authors.initials: SS
authors.lastname: Gursu
authors.forename: Aysegul
authors.initials: A
authors.lastname: Bursali
authors.forename: Vedat
authors.initials: V
authors.lastname: Sahin
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005270:Femur Head / Q000601:surgery*; D006621:Hip Joint / Q000601:surgery*; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000601:surgery*; D008297:Male; D010027:Osteotomy / Q000379:methods*; D010388:Pelvis / Q000601:surgery*; D011379:Prognosis; D016896:Treatment Outcome