Early clinical and radiological outcomes after double osteotomy in patients with late presentation Legg-Calvé-Perthes disease .
Journal of Children Orthopaedics, Vol 2 (6) Dec 2008
Carlos A. Sarassa1, 2, Ana Milena Herrera2 , Jaime Carvajal2, Luisa F. Gomez2, Camilo A. Lopez2 and Andres F. Rojas2
(1) Department Orthopedics and Trauma, Clínica del Campestre, Pablo Tobon Uribe Hospital HPTU, UPB University, Medellín, Colombia
(2) Department of Basic Sciences and Epidemiology, School of Medicine, CES University, Calle 10ª #22-04. Universidad CES, Medellín, Colombia
(1) Department Orthopedics and Trauma, Clínica del Campestre, Pablo Tobon Uribe Hospital HPTU, UPB University, Medellín, Colombia
(2) Department of Basic Sciences and Epidemiology, School of Medicine, CES University, Calle 10ª #22-04. Universidad CES, Medellín, Colombia
Abstract
Purpose Legg-Calvé-Perthes disease is an idiopathic avascular necrosis of the femoral head. Although many surgical approaches to treat the late presentation of this pathology have been proposed, there are few reports about the early results of the double osteotomy procedure (femoral varus osteotomy combined with Salter innominate osteotomy). The purpose of this study was to describe the early results obtained with the double osteotomy in patients with late presentation of Legg-Calvé-Perthes disease.
Methods Cross-sectional evaluation of ten patients intervened with double osteotomy. There were seven males and three females with a mean age of 9.2 ± 1.7 years [standard deviation (SD)]. The average post-surgical time of evaluation was of 46.5 ± 26.2 months.
Results Of the ten evaluated patients, four had a Catterall III and six had a Catterall IV disease. According to Herring classification, three patients were Herring B and seven were Herring C. The epiphyseal extrusion average before and after the surgical procedure was 19.3 ± 12.4 and 12.1 ± 14.9%, respectively. In accordance with the Ratliff classification and Lloyd Roberts radiological results, the following were the postoperative clinical results: four good, five fair and one poor. Based on the Stulberg classification, there was one patient in class I, five in class II, three in class III and one in class IV.
Conclusion The surgical treatment for late Perthes disease with the best expected outcome is still a challenge. According to the resultsreported here, the double osteotomy could be considered as an alternative to treat this entity
Purpose Legg-Calvé-Perthes disease is an idiopathic avascular necrosis of the femoral head. Although many surgical approaches to treat the late presentation of this pathology have been proposed, there are few reports about the early results of the double osteotomy procedure (femoral varus osteotomy combined with Salter innominate osteotomy). The purpose of this study was to describe the early results obtained with the double osteotomy in patients with late presentation of Legg-Calvé-Perthes disease.
Methods Cross-sectional evaluation of ten patients intervened with double osteotomy. There were seven males and three females with a mean age of 9.2 ± 1.7 years [standard deviation (SD)]. The average post-surgical time of evaluation was of 46.5 ± 26.2 months.
Results Of the ten evaluated patients, four had a Catterall III and six had a Catterall IV disease. According to Herring classification, three patients were Herring B and seven were Herring C. The epiphyseal extrusion average before and after the surgical procedure was 19.3 ± 12.4 and 12.1 ± 14.9%, respectively. In accordance with the Ratliff classification and Lloyd Roberts radiological results, the following were the postoperative clinical results: four good, five fair and one poor. Based on the Stulberg classification, there was one patient in class I, five in class II, three in class III and one in class IV.
Conclusion The surgical treatment for late Perthes disease with the best expected outcome is still a challenge. According to the resultsreported here, the double osteotomy could be considered as an alternative to treat this entity
Felicitaciones a Carlos, no solo por lo interesante y por el esfuerzo que todos sabesmos implica publicar, sino por el teson de hacerlo a pesar de todo. Seguamos ( me incluyo) su ejemplo.
ResponderEliminarGustavo Molina
Es maravilloso volver a contar con este medio de integración académica y de enriquecimiento grupal. Me siento muy contento de tener nuevamente a nuestro lado un motor como el Dr. Carlos Valderrama, que siempre está inyectándonos crecimiento y academia.
ResponderEliminarGracias a Mamut por dejarnos compartir con su papá!
que bueno que volmimos, al profesor Sarassa felicitaciones, una vez mas demuestra que si se puede. Debemos seguir su eljemplo
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