Why the study?
Does combined osteotomy improve clinical and radiographic outcomes in patients with severe Legg-Calvé-Perthes disease?
Does combined osteotomy improve clinical and radiographic outcomes in patients with severe Legg-Calvé-Perthes disease?
Combined Salter innominate and varus femoral osteotomies appear to be a safe and effective salvage procedure for severe Legg-Calvé-Perthes disease, yielding good clinical and radiographic outcomes at long-term follow-up.
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May support combined osteotomies in severe Perthes; hypothesis-generating in small Level 5 series.
Combined Salter innominate and varus femoral osteotomies were performed on 14 patients with severe Legg-Calvé-Perthes disease. The mean patient age was 8 years 4 months. Nine hips were Catterall class III, five class IV, and all had three or more head-at-risk signs. The average preoperative epiphyseal index was 30%. Mean follow-up was 8 years. Eleven of 14 patients had a good clinical result, and radiographs showed progressive spherical remodeling of the femoral head. Seven hips demonstrated spherical congruency at follow-up. The epiphyseal extrusion index at follow-up was less than 20% in 13 of 14 hips. We conclude that combined osteotomy is a safe and effective salvage procedure in severe Legg-Calvé-Perthes disease.
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Crutcher et al. (1992) studied this question.
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