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Age at onset, extent of necrosis, and containment in Perthes disease. Results at maturity.

Research paper by Andreas A Roposch, Johannes J Mayr, WolfgangB E WE Linhart

Indexed on: 02 May '03Published on: 02 May '03Published in: Archives of Orthopaedic and Trauma Surgery



Abstract

The concept of containment of the femoral head within the acetabulum has been popularised as a principle of treatment in Perthes disease. The results of 30 patients treated for Perthes disease following a predefined scheme based on the containment were analyzed.All children were treated with abduction braces as long as containment was maintained. However, 15 of them required surgery due to failure of containment in the further course of the disease. All children were followed until skeletal maturity.Within a mean follow-up period of 8 years and 9 months (range 5-13 years), all patients showed good clinical function. On radiographic assessment, 70% of the hips were Stulberg classes I and II, with a good prognosis.Failure of the containment was influenced by age at onset and extent of necrosis. Weight-bearing abduction braces cannot be recommended in children who are 6 years and older and show femoral head involvement of more than 50%.