A Long-Term Study of Alignment Correction Following Proximal Femoral Varus Osteotomy and Pemberton Osteotomy in Children With Legg–Calvé–Perthes Disease and Developmental Dysplasia of the Hip

Figures

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  FIGURE 1. Radiological measurements. (A) The inferolateral angle between the anatomical axis of the femur and the tibia was defined as the femorotibial angle (FTA). (B) The mechanical axis of the leg was a line drawn through the center of the femoral head and the center of the tibial plafond, and M was the point of intersection between the knee and the mechanical axis. The mechanical axis deviation (MAD) was defined as the ratio of the distance between the mechanical axis and the lateral-most part of the tibia plateau to the width of the tibial plateau. MAD = (mb/ab) × 100%. (C) The superomedial angle between the anatomical axis of the tibia and the upper surface of the talus was defined as the tibiotalar angle (TTA). (D) The inferomedial angle between the longitudinal axis of the neck and shaft of the femur was defined as the femoral neck-shaft angle (FNSA). (E) The lateral angle between the mechanical axis of the femur and the lower surface of the femoral condyle was defined as the mechanical lateral distal femoral angle (mLDFA). (F) The leg length was defined as the distance between the top of the femoral head and the midpoint of the tibial plafond. Leg length = cd.

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  FIGURE 2. Serial change in the radiological measurements up to the final assessment in patients with Legg–Calvé–Perthes disease (LCPD) or developmental dysplasia of the hip (DDH) who were treated with proximal femoral varus osteotomy (PFVO) and Pemberton osteotomy. (A) Femoral neck-shaft angle of patients with LCPD. (B) Femoral neck-shaft angle of patients with DDH. (C) Femorotibial angle of patients with LCPD. (D) Femorotibial angle of patients with DDH. (E) Mechanical lateral distal femoral angle (mLDFA) of patients with LCPD. (F) mLDFA of patients with DDH. NS, not significant.

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  FIGURE 3. A boy aged 6 years 4 months with Legg–Calvé–Perthes disease (LCPD) who underwent the index procedures. (A) A preoperative standing anteroposterior pelvis view. (B) A postoperative anteroposterior pelvis view. (C) The latest standing anteroposterior pelvis view 76 months after the operation. (D) A preoperative scanogram. (E) The latest scanogram 76 months after the operation.

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  FIGURE 4. A girl who had open reduction and Pemberton procedure for left hip developmental dysplasia of the hip (DDH) earlier underwent the proximal femoral osteotomy for coxa valga. (A) A preoperative standing pelvis anteroposterior view. (B) A postoperative standing pelvis anteroposterior view. (C) The latest standing pelvis anteroposterior view 61 months after the operation. (D) A preoperative scanogram. (E) The latest scanogram 61 months after the operation.