Surgical treatment of children with severe forms of Perthes disease
Abstract
Purpose. To analyze the immediate and intermediate results of using femoral aligning osteotomy combined with device-assisted joint decompression in children with Perthes disease.
Materials and Methods. The results of treatment of 16 children with Perthes disease at fragmentation stage analyzed. Mean age during surgery was 7 years and 4 months (6-9 years). Joint distribution according to Catterall criteria: Group III – 9, Group IV – 7. Joint distribution according to Herring criteria: Group В/С – 10, Group С – 6. X-ray image conformed to Stage IV (в) according to Veselovskii classification in all cases. The technique of femoral aligning osteotomy in combination with non-articulation device-assisted decompression, tunnelization, subchondral cellularand- tissue transplantation used. Mean follow-up was 3 years (2-5 years).
Results. Functional outcomes according to McKey: Grade I – 13 joints, Grade II – 3 joints. X-ray results according to Stulberg: Grade I – 2 joints, Grade II – 8 joints, Grade III – 5 joints, Grade IV – 1 joint. The share of good outcomes was 63%, unsatisfactory ones – 6.7%.
Conclusion. The technology presented can be used effectively in treatment of severe forms of Perthes disease as an alternative to known surgical interventions.
Materials and Methods. The results of treatment of 16 children with Perthes disease at fragmentation stage analyzed. Mean age during surgery was 7 years and 4 months (6-9 years). Joint distribution according to Catterall criteria: Group III – 9, Group IV – 7. Joint distribution according to Herring criteria: Group В/С – 10, Group С – 6. X-ray image conformed to Stage IV (в) according to Veselovskii classification in all cases. The technique of femoral aligning osteotomy in combination with non-articulation device-assisted decompression, tunnelization, subchondral cellularand- tissue transplantation used. Mean follow-up was 3 years (2-5 years).
Results. Functional outcomes according to McKey: Grade I – 13 joints, Grade II – 3 joints. X-ray results according to Stulberg: Grade I – 2 joints, Grade II – 8 joints, Grade III – 5 joints, Grade IV – 1 joint. The share of good outcomes was 63%, unsatisfactory ones – 6.7%.
Conclusion. The technology presented can be used effectively in treatment of severe forms of Perthes disease as an alternative to known surgical interventions.
Review
For citations:
, Surgical treatment of children with severe forms of Perthes disease. Genij Ortopedii. 2013;(1). (In Russ.)
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