Late Results of Perthes' Disease

This paper is concerned with an investigation of the late clinical and radiological results of Pcrthes' disease. M A T E R I A LThe material consisted of 40 patients with Perthes' disease.The diagnosis was radiologically verified in all cases.Two patients had in the meantime emigrated, 2 had died and one could not be traced.The remaining 35 patients (28 men and 7 women) were after-examined clinically and radiologically (Table I).The interval hetwcen the onset of the disease and the present after-examination was a t least 20 years; on the average, 33 years (32 for men and 37 for women).The disease was right-sided in 22 cases and left-sided in 13.The average age at onset was 7.4 years (7.7 in the men and 6.0 in the women).The lowest age at onset was 3 years: the highest, 13 years.All patients except 2 had been treated with bed-rest.The average duration was 6.1 months.In 23 cases (19 men and 4 women) the hip was immobilised in plaster for an average period of 3.2 months.Except in 2 cases treatment included freedom from weight-bearing (plaster, hed-rest, crutches) for, on the average, 6.6 months. M E T H O D SThe patients were after-examined clinically and radiologically in 1964.Thirteen of the patients had also been examined radiologically in 1949-1955.The clinical examination included evaluation of pain, range of motion and restriction of function (Danielsson 1964).Radiological evaluation1 was performed on frontal, lateral and Lauenstein views.The degree of arthrosis was assessed according to Heripret's schema (Danielsson et al. 1964).The series was divided into 4 groups according to degree of deformity of the femoral head.Lowest degrees of deformity in the different groups 1, 2 and 3 are illustrated in Figs. 1, 2 and 3.The length of the caput-rollum was measured, after which the ratios between the values of the hip joint without and with Perthes' disease were calculated.