Study on Functional Outcome of VDRO in Late-Presenting Perthes Disease in Paediatric

Background: Perthes disease is a pediatric hip disorder characterized by avascular necrosis of the femoral head, with late presentation (after age seven) often associated with poor prognosis and controversy over optimal management. This study aims to assess the functional outcomes of varus derotation osteotomy (VDRO) in children with late-presenting Perthes disease. Aim of the study: The aim of the study was to evaluate the functional outcomes of Varus Derotation Osteotomy (VDRO) in paediatric patients with late-presenting Perthes disease. Methods: This prospective study at the Department of Orthopaedics, Sylhet MAG Osmani Medical College Hospital (2023-24) evaluated VDRO in 14 children (8-12 years) with unilateral Perthes (Herring B/C). Patients underwent subtrochanteric osteotomy (15-20° varus correction, DCP fixation) followed by 6-week spica casting. Functional outcomes were assessed using Harris Hip Score over 6 months. Data were analyzed using SPSS v25. Results: This study included 14 paediatric patients with late-presenting Perthes disease treated by VDRO. Most were aged 8–10 years (64.29%) and male (71.00%), with right-side involvement in 57.14%. Based on the modified Elizabethtown classification, Stage I B was most common, and 57.14% were classified as Herring’s Group B. Postoperatively, 57.14% had excellent to good outcomes per Harris Hip Score, while complications were minimal, with hypertrophic scar being the most frequent. Conclusion: VDRO is an effective treatment for late-presenting LCPD in adolescents, yielding favorable functional outcomes and manageable complications.