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: Sung Soo Kim, Chan Woo Lee, Hyeon Jun Kim, Hyun Ho Kim, Lih Wang
• Journal: Clinics in orthopedic surgery (Clin Orthop Surg) Vol. 8 Issue 4 Pg. 452-457 (Dec 2016) ISSN: 2005-4408 [Electronic] Korea (South)
• PMID: 27904729 (Publication Type: Journal Article)

Topics

• Child
• External Fixators
• Female
• Fracture Fixation (instrumentation, methods)
• Humans
• Legg-Calve-Perthes Disease (diagnostic imaging, surgery)
• Male
• Retrospective Studies