Functional adaptation after femoral intertrochanteric valgus osteotomy in Legg–Calvé–Perthes disease

Figures

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  Figure 1. Deformed and enlarged femoral head with hinge abduction phenomenon. (A) In abduction the lateral part of the femoral head hinges against the acetabular rim; filled circle = lateralized centre of rotation. (B) Adduction of the hip demonstrates the conditions with VOF: filled circle = centered centre of rotation. (C) Proceeded proximal femoral valgus osteotomy resulting in a distancing of the lateral femoral deformation and therefore reducing hinge abduction in a normal standing position.

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  Figure 2. (A) Definition of the pelvic-femoral angle (PFA): angle between the anatomical diaphyseal line of the femur and a vertical line through the pelvis in the a.p. view (from the left to the right anterior inferior iliacal spine). The image shows a 11-year old patient. (B) Postoperative X-ray during VOF of the right hip 6 weeks after surgery. (C) Final X-ray after full maturation of the patient (17 years). The initial PFA of 78° was increased to 84°.

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  Figure 3. (A) T-values of Kidscreen-10 at LFU and (B) T-values grouped by the Stulberg classification. Change in clinically evaluated abduction (C) and internal rotation (D) preOP, postOP and at LFU. Boxpolts are defined as bottom and top of box = 25th and 75th percentiles, thick line inside box = mean, thin line inside box = median, I bar = maximum and minimum of data, and circle with slash = outlier.

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  Figure 4. (A) PFA over time preOP, postOP and at LFU. (B) ATD over time preOP, postOP and at LFU compared to the unaffected side. For significant differences see Tables 4 and 5. Boxpolts are defined as bottom and top of box = 25th and 75th percentiles, thick line inside box = mean, I bar = maximum and minimum of data, and circle with slash = outlier.