title: Treatment of Late-Onset Legg-Calve-Perthes Disease by Arthrodiastasis.
abstract: BACKGROUND
  To evaluate the efficacy of arthrodiastasis for Legg-Calve-Perthes disease.
  
  
  METHODS
  Arthrodiastasis was conducted using external fixator devices (Orthofix) in 7 patients at least 8 years of age with a diagnosis of Legg-Calve-Perthes disease. The average follow-up was 80 months (range, 32 to 149 months), and their average age was 9.1 years (range, 8 to 12 years). The results of treatment were evaluated by measuring the degree of hip pain and the range of motion of the hip at 6 months after the operation and comparing the values with preoperative measurements. Radiological recovery was evaluated by the epiphyseal index and compared with the preoperative values. At the final follow-up, clinical and radiological results were evaluated using the Iowa hip score and the Stulberg classification.
  
  
  RESULTS
  On the clinical evaluation performed at 6 months after arthrodiastasis, the degree of pain decreased by 1.8 points on average, and the average flexion, internal rotation, and abduction increased by 35°, 16°, and 11°, respectively. Based on radiological findings, the epiphyseal index showed a remarkable increase of 6.6 on average (from 19 preoperatively to 26 postoperatively). At the final follow-up, the average Iowa hip score improved from 65 points preoperatively to 84 points. There were 1 Stulberg class I hip, 2 Stulberg class II hips, 3 Stulberg class III hips, 1 Stulberg class IV hip, and no Stulberg class V hip.
  
  
  CONCLUSIONS
  We conclude that arthrodiastasis using an external fixator can be a relatively promising surgical procedure for the treatment of late-onset Legg-Calve-Perthes disease.
authors.affiliation: Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Chan Woo
authors.initials: CW
authors.lastname: Lee
authors.affiliation: Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Hyeon Jun
authors.initials: HJ
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Hyun Ho
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Dong-A University College of Medicine, Busan, Korea.
authors.forename: Lih
authors.initials: L
authors.lastname: Wang
mesh_terms: D002648:Child; D016267:External Fixators; D005260:Female; D005592:Fracture Fixation / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies
keywords: Arthrodiastasis; Epiphyseal index; Iowa hip score; Legg-Calve-Perthes disease; Stulberg classification