Summary
A tentative classification of Perthes'disease according to the extent of epiphyseal and metaphyseal involvement in lateral radiographs of the hip was applied to 61 hips in 55 patients. Forty-four hips were treated by containment (Tachjian's trilateral socket hip abduction orthosis) and 17 hips were treated surgically either by intertrochanteric or sub-trochanteric osteotomy.
The results correlated well with the classification of the authors. The greater the extent of involvement of the epiphysis and metaphysis, the severer the resulting deformity. The choice of method of treatment is also discussed.
It is concluded that this classification may be of prognostic value and may be useful to differentiate atypical cases.
Résumé
Une tentative de classification de la maladie de Legg-Calvé-Perthes, en fonction de l'étendue de l'atteinte épiphyso-métaphysaire sur une radiographie de profil de la hanche, a été appliquée à 55 malades (61 hanches). Quarante-quatre hanches ont été traitées par la méthode de contention (orthèse d'abduction de Tachdjian) et 17 hanches ont été traitées chirurgicalement, soit par ostéotomie intertrochantérienne soit par ostéotomie sous-trochantérienne.
Les résultats correspondent bien avec la classification des auteurs. Plus la lésion est étendue dans l'épiphyse et la métaphyse, plus la déformation rencontrée est sévère. Le choix des méthodes de traitement est également discuté en fonction des résultats.
On peut conclure que cette classification a une certaine valeur pronostique et qu'elle est utile pour différencier les cas atypiques.
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Hirohashi, K., Kanbara, T., Kuroda, K. et al. Perthes'disease — A classification based on the extent of epiphyseal and metaphyseal involvement. International Orthopaedics 4, 47–55 (1980). https://doi.org/10.1007/BF00266603
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DOI: https://doi.org/10.1007/BF00266603