Transtrochanteric rotational osteotomy for Legg-Calvé-Perthes disease

• Published in: Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 1997-11, Vol.2 (6), p.396-404
• Main Authors: Hotokebuchi, Takao, Kubota, Hideaki, Mohtai, Masaaki, Jingushi, Seiya, Fukuoka, Shinji, Iwamoto, Yukihide, Sugioka, Yoichi
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; hip; Hip joint; Legg-Calvé-Perthes disease; Medical sciences; Orthopedic surgery; osteonecrosis; Perthes’ disease; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; transtrochanteric rotational osteotomy
• ISSN: 0949-2658; 1436-2023
• DOI: 10.1007/BF02488927

A retrospective review identified 20 hips in 19 children with Legg-Calvé-Perthes disease (Perthes’ disease) who underwent transtrochanteric rotational osteotomy. Indications depend on patient age and the radiographic appearances. This procedure is indicated for children over 9 years of age with widespread involvement, especially in the lateral-superior area. In those under nine years of age, lateralization of the femoral head without full containment and hinge abduction are indicated. The prerequisite for this osteotomy is a healed or intact round femoral head either anteriorly or posteriorly. The average age at the time of initial symptoms was 8 years and 10 months. Age at operation ranged from 7 years and 1 month to 15 years and 7 months (avevage, 10 years and 10 months). The follow-up period ranged from 3 years to 13 years and 4 months (average, 7 years and 1 month). At the final follow-up, the patients showed few clinical problems. Radiographs of all patients demonstrated containment of the femoral head. The clinical and radiographic results of this treatment for Perthes’ disease were considered to be satisfactory. We therefore recommend this osteotomy as an effective alternative treatment for severe Perthes’ disease.