title: Hip arthrodiastasis in Legg-Calvé-Perthes disease.
abstract: OBJECTIVE
  Arthrodiastasis consists of the mobilisation of the hip while distracted by a hinged distractor. The aim of our study is to show the results of the treatment of late-onset Perthes disease with this technique in our institution.
  
  
  METHODS
  Ambispective review of all the cases that underwent this surgery in our Department of Paediatric Orthopaedics between 2010 and 2014 with the following inclusion criteria: patients over 8 years old, with minimal deformity, and poor prognosis. Mobility, pain, Trendelenburg sign, radiographic sphericity, and complications were assessed.
  
  
  RESULTS
  A total of 13 patients (9 male, 4 female) were included. The mean age was 11.93 years. Radiographic risk signs were present in 7 cases. The mean decrease in pain measured with a visual analogue scale (VAS) after the surgery was 3.83 points (P<.05). Cephalic sphericity was maintained in 11 cases during follow up (1.75 years). Complications were observed complications in 84.6% of the patients, with infection of the screw tract being the most frequent. All of them were easy to treat.
  
  
  CONCLUSIONS
  Arthrodiastasis is a minimally invasive technique, useful in the treatment of late onset Perthes disease. It improves clinical results and maintains cephalic shape when applied in early stages. However, it is not free of complications, which can involve as many as 8 out of 10 patients treated with the technique.
authors.affiliation: Hospital Infantil Universitario Niño Jesús, Madrid, España; Hospital Universitario del Río Hortega, Valladolid, España. Electronic address: i.aguadomaestro@gmail.com.
authors.forename: I
authors.initials: I
authors.lastname: Aguado-Maestro
authors.affiliation: Hospital Infantil Universitario Niño Jesús, Madrid, España; Hospital Ruber Internacional, Madrid, España.
authors.forename: J C
authors.initials: JC
authors.lastname: Abril
authors.affiliation: Hospital Infantil Universitario Niño Jesús, Madrid, España; Hospital Universitario del Río Hortega, Valladolid, España.
authors.forename: A
authors.initials: A
authors.lastname: Bañuelos Diaz
authors.affiliation: Hospital Universitario del Río Hortega, Valladolid, España.
authors.forename: M
authors.initials: M
authors.lastname: García Alonso
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D016267:External Fixators; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000601:surgery*; D008297:Male; D019637:Orthopedic Procedures / Q000295:instrumentation / Q000379:methods*; D011446:Prospective Studies; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Arthrodiastasis; Artrodiastasis; Enfermedad de Legg-Calve-Perthes; External fixation; Fijador externo; Legg-Calve-Perthes disease