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Legg–Calvé–Perthes disease affecting children less than eight years of age: a paired outcome study

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Abstract

There is controversy as to whether operative treatment in Legg–Calvé–Perthes (LCP) disease improves the outcome obtained by conservative treatment. This article describes a paired study of mature patients, diagnosed with LCP disease before the age of 8 years, to compare the radiological results after conservative or surgical management. Patients were paired with strict matching of gender, body mass index, age at onset, disease stage at the first visit, necrotic area, and radiological at-risk signs. Each pair was assessed by comparing the values of five radiological measurements. Fourteen pairs (28 hips) fitted the criteria. The only radiological measure which showed a statistically better result in the surgical group was femoral head sphericity as measured by Mose’s method. However, there was no difference between the two groups for Stulberg class. Our study supports the hypothesis that for hips affected with LCP disease under the age of 8 years, surgery does not improve the outcome.

Résumé

Il existe une controverse dans le traitement de la maladie de Perthes, notamment lorsque l’on affirme que le traitement opératoire améliore l’évolution obtenue après traitement conservateur. Matériel et méthode : nous avons réalisé une étude comparative de patients en fin de croissance dont le diagnostic de la maladie de Perthes avait été réalisé avant l’âge de 8 ans avec comparaison des résultats radiologiques et après traitement conservateur ou chirurgical. Ces patients ont été appariés de façon stricte par âge, DMI, sexe, lors de la première visite. De même, en ce qui concerne les zones nécrotiques et les signes radiologiques de tête à risque. Pour chaque groupe on a évalué cinq critères radiologiques. 14 paires de patients (28 hanches) ont ainsi été étudiés. Résultats, la seule mesure radiologique qui permet d’avoir le meilleur résultat sur le plan statistique est celle dont le groupe présente des têtes fémorales strictement sphériques, selon la technique mesurée de Mose. Cependant, il n’y a pas de différence entre les deux groupes qui sont classés selon Stulberg. Conclusion : notre étude, permet de démontrer l’hypothèse suivante pour les hanches atteintes d’une maladie de Perthes à l’âge de 8 ans, la chirurgie n’améliore pas les résultats.

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Author notes

  1. S. Shewale & M. Sibinski

    Present address: , Maratonska 91 m. 54, 94-004, Lodz, Poland

Authors and Affiliations

  1. Royal Hospital for Sick Children, Glasgow, G38SJ, Scotland

    D. A. Sherlock

  2. Queen Margaret Hospital, Dunfermline, Fife, Scotland

    S. Sharma

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  1. S. Sharma
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  2. S. Shewale
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  3. M. Sibinski
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  4. D. A. Sherlock
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Correspondence to M. Sibinski.

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No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Sharma, S., Shewale, S., Sibinski, M. et al. Legg–Calvé–Perthes disease affecting children less than eight years of age: a paired outcome study. International Orthopaedics (SICO 33, 231–235 (2009). https://doi.org/10.1007/s00264-007-0500-0

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  • DOI: https://doi.org/10.1007/s00264-007-0500-0

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