Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Park, Kwang Won; Jang, Kyu Seon; Song, Hae Ryong

doi:10.1007/s11999-013-3009-4

Cited by 17 publications

(9 citation statements)

References 30 publications

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“…The most important predictor of leg length discrepancy (LLD) is the extent of lateral pillar involvement and no other factor (including age, sex, and treatment modality) is correlated with LLD at skeletal maturity. 17,20 In the present study we used an openwedge osteotomy as persistent limb shortening tends to be greater after a closed-wedge osteotomy in the older child. We did not see any progressive change in this parameter during the follow-up period, especially after hardware removal and in the younger boys, but it may decrease with time as the varus angulation of the subtrochanteric osteotomy gradually changes.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Varus Derotation Osteotomy for Containment of Femoral Head in Advanced Perthes Disease

Rana¹,

Datta

Bhuiyan³

et al. 2021

J Enam Med Col

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Background: Legg-Calve-Perthes (LCP) disease, or idiopathic avascular necrosis of the femoral head occurs during early childhood and is caused by impaired circulation in the femoral head. Varus derotation osteotomy (VDO) was described over half a century ago, and is now a popular method for the operative treatment of Perthes disease. Objective: To find out the clinical and radiological outcome of varus derotation osteotomy for containment of femoral head in advanced Perthes disease. Materials and Methods: This observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from March 2015 to September 2017. Total 20 cases of advanced Perthes disease were enrolled. Pre- and post-operative period were evaluated by interview and clinical examination by using a semi-structured questionnaire. Demographic and clinical information were recorded. All patients had a pre- and post-operative x-rays. We used visual analog scales (VAS) for scoring pain; Wiberg’s central edge angle, epiphyseal extraction index, neck shaft angle and Larson (Iowa) hip score were used to assess the outcome of VDO. Comparison of continuous variables between the two groups was made with Student’s t-tests. Comparison of proportions between Herring groups B and C were made with chi-square tests. p<0.05 was considered as significant. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Sciences (SPSS 22.0). Results: In the present study, mean visual analog scale (VAS) score and epiphyseal extraction index (EEI) were significantly (p<0.001) lower in Herring Group B in comparison to that of Group C, but mean WCEA, NSA and HLS were significantly (p<0.001) higher in Herring Group B in comparison to that of Group C. Conclusion: Varus osteotomy gives good results in children aged 6–12 years who do not exhibit any femoral head deformity or flattening, especially those with good containment in abduction in advance Perthes disease. J Enam Med Col 2020; 10(2): 79-85

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Section: Discussionmentioning

confidence: 99%

Outcome of Varus Derotation Osteotomy for Containment of Femoral Head in Advanced Perthes Disease

Rana¹,

Datta

Bhuiyan³

et al. 2021

J Enam Med Col

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“…4,20 This approach simultaneously allows for assessment and treatment of intraarticular FAI and related chondro-labral pathology. The extraarticular deformity remains a major component of SCFE, [31][32][33][34][35] including trochanteric overgrowth, reduced abductor lever arm and limb shortening, all of which have to be simultaneously addressed to optimize the surgical outcome.…”

Section: Discussionmentioning

confidence: 99%

Combined Imhauser osteotomy and osteochondroplasty in slipped capital femoral epiphysis through surgical hip dislocation approach

Baraka

Hefny

Thakeb

et al. 2020

Journal of Children's Orthopaedics

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Purpose Treatment of moderate to severe stable slipped capital femoral epiphysis (SCFE) remains a challenging problem. Open reduction by modified Dunn procedure carries a considerable risk of osteonecrosis (ON). Imhauser osteotomy is capable of realigning the deformity without the risk of ON, but the remaining metaphyseal bump is implicated with significant chondro-labral lesions and accelerated osteoarthritis. We conducted this study to evaluate the efficacy and safety of Imhauser osteotomy combined with osteochondroplasty (OCP) through the surgical hip dislocation (SHD) approach. Methods A prospective series of 23 patients with moderate-severe stable SCFE underwent Imhauser osteotomy and OCP through SHD. The mean age was 14.4 years (13 to 20) and the mean follow-up period was 45 months (24 to 66). The outcome measures included clinical and radiological parameters and Harris hip score (HHS) was used as a functional score. Results The mean HHS improved significantly from 65.39 to 93.3. The limb length discrepancy improved by a mean of 1.72 cm. The mean flexion and abduction arcs showed a significant improvement (mean increase of 37.5° and 18.5°, respectively). The mean internal rotation demonstrated the most significant improvement (mean increase of 38.5°). All the radiographic parameters improved significantly; including anterior and lateral slip angles (mean improvement 37.52° and 44.37°, respectively). The mean alpha angle decreased by 39.19°. The articulo-trochanteric distance significantly increased to a mean of 23.26 mm. No cases of ON or chondrolysis were identified. Conclusion Combined Imhauser osteotomy and OCP through the surgical dislocation approach provide a comprehensive and safe management of moderate to severe stable SCFE. Level of evidence IV

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“…While, incidence rates vary considerably between countries, there is also significant variation within countries and even within regions. [9][10][11] Lameness and pain at the diseased site are the major characteristics of this disease. For some patients, there is no discomfort or pain at the hip during the early stages of the disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical observation of early rehabilitation of childhood femoral head necrosis in a low stress environment

Nie

Dai

et al. 2015

Int Surg J

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Can Residual Leg Shortening Be Predicted in Patients With Legg-Calvé-Perthes’ Disease?

Cited by 17 publications

References 30 publications

Outcome of Varus Derotation Osteotomy for Containment of Femoral Head in Advanced Perthes Disease

Outcome of Varus Derotation Osteotomy for Containment of Femoral Head in Advanced Perthes Disease

Combined Imhauser osteotomy and osteochondroplasty in slipped capital femoral epiphysis through surgical hip dislocation approach

Clinical observation of early rehabilitation of childhood femoral head necrosis in a low stress environment

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