Double osteotomy in the surgical treatment of Perthes’ disease: Dega's transiliac osteotomy and subtrochanteric osteotomy
Journal Title: Ortopedia Traumatologia Rehabilitacja - Year 2004, Vol 6, Issue 6
Abstract
Background. The combination of Dega transililiac and femoral subtrochanteric is used in our department in the treatment of Legg-Calvé-Perthes' disease. Subtrochanteric osteotomy, initially performed as varus-derotation osteotomy, is now mainly extension osteotomy with shortening. Femoral shortening is crucial for joint decompression and makes room for pelvic redirection after pelvic osteotomy.Material and methods. 34 children (36 hips) were analyzed retrospectively. All children were operated using subtrochanteric osteotomy with shortening and Dega's transiliac osteotomy of the pelvis. There were several variants of subtrochanteric osteotomy: extension osteotomy only, varus-extension, extension-varus-derotation, extension-derotation, and varus-derotation. In one case only varus osteotomy was performed. Before surgery 18 hips were Catterall group IV, 14 group III and 4 group II; in the Herring classification, 24 hips were group B, 11 group C, and 1 group A. All patients were evaluated clinically and radiologically at follow-up using the Stulberg classification. The mean follow-up was 8 years.Results. In the Stulberg classification 4 hips were scored after surgery as group I, 23 as group II, 4 as group III, 4 as group IV and only 1 hip as group V. In 6 patients limping was observed, 2 patients had a positive Trendelenburg sign, and 11 a positive Duchenne sign. The mean shortening of the lower limb was 0.25 cm. Six patients complained of pain after physical activity.Conclusion. Subtrochanteric shortening osteotomy of the femur combined with Dega transiliac osteotomy is a safe and valuable procedure for surgical treatment of Perthes' disease.
Authors and Affiliations
Marek Napiontek, Szymon Pietrzak
Keywords
Related Articles
- EP ID EP56315
- DOI -
- Views 83
- Downloads 0
Leczenie operacyjne utrwalonych, sztywnych, neurogennych stóp wydrążonych i szpotawych u dorosłych
Wstęp. Sztywna stopa wydrążona i szpotawa jest wielopłaszczyznową deformacją powstałą na podłożu zaburzeń ner-wowo-mięśniowych. Powoduje trudność w samodzielnym poruszaniu się, niestabilność stawu skokowo-goleniowego, zł...
Distal Humeral AO type C Fracture - Analysis of LCP Fixation
Background. Distal humeral fractures of type C by AO are serious musculoskeletal injuries, affecting the function of the elbow and upper limb. The authors present the results of treatment of these injuries with the use o...
Treatment of injury of the triangular fibrocartilage complex (TFCC).
Background. The triangular fibrocartilage complex (TFCC) supplies stability and cushioning for proper wrist function. TFCC lesions, a common cause of ulnar-sided wrist pain, can be traumatic (Palmer I) or degenerative (P...
Neuropathological Aspects of Conservative Treatment of Scoliosis. A Theoretical View Point.
Abstract An upright body posture cannot be maintained passively for reasons including a high location of the centre of gravity (COG) and a small support area. Proper alignment of body parts is maintained au-tomatically,...
Choroba Alzheimera a osteoporoza: wspólne czynniki ryzyka czy też jedna choroba predysponuje do drugiej
Zarówno choroba Alzheimera, jak i osteoporoza występują głównie u osób po 60 roku życia. W praktyce klinicznej obserwuje się częstewspółwystępowanie obu tych chorób, a tylko nieliczni badacze na świecie zajmowali się tym...