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The treatment of Legg-Calvé-Perthes disease

To contain or not to contain

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Abstract

In order to evaluate a treatment protocol involving a non-containment method and femoral osteotomy when lateral subluxation of the femoral head develops, 39 children with 42 affected hips were examined radiologically an average of 7 years (4–1610/12) following the onset of Legg-Calvé-Perthes disease. Twenty-six hips were treated conservatively with an ischial-bearing, Thomas-type splint and 16 with a femoral varus derotating osteotomy. Both Catterall and Herring gradings were used. The end result was evaluated according to the Stulberg classification. All Catterall grade I (n = 8) hips had a satisfactory result regardless of age at onset and method of treatment. In Catterall groups II–IV (n = 34), age at onset influenced the treatment outcome. In children affected before the age of 8 years, results of conservative treatment were originally satisfactory but were seen to deteriorate with advancing age. In children over 8 years old (n = 13), the results clearly favour operative containment.

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Authors and Affiliations

  1. Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Essen, Hufelandstrasse 55, D-45122, Essen, Germany

    H. Grasemann

  2. Orthopddische Klinik und Poliklinik, Universitätsklinikum Essen, Germany

    R. D. Nicolai, T. Patsalis & M. Hövel

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  1. H. Grasemann
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  2. R. D. Nicolai
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  3. T. Patsalis
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  4. M. Hövel
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Grasemann, H., Nicolai, R.D., Patsalis, T. et al. The treatment of Legg-Calvé-Perthes disease. Arch Orthop Trauma Surg 116, 50–54 (1997). https://doi.org/10.1007/BF00434101

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  • DOI: https://doi.org/10.1007/BF00434101

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