Comparison between Salter's innominate osteotomy and augmented acetabuloplasty in the treatment of patients with severe Legg-Calve-Perthes disease. Analysis of 90 hips with special reference to roentgenographic sphericity and coverage of the femoral head

Comparison between Salter's innominate osteotomy and augmented acetabuloplasty in the treatment of patients with severe Legg-Calve-Perthes disease. Analysis of 90 hips with special reference to roentgenographic sphericity and coverage of the femoral head

Autor Kuwajima, S. S. Google Scholar
Crawford, A. H. Google Scholar
Ishida, A. Google Scholar
Roy, D. R. Google Scholar
Laredo, J. Google Scholar
Milani, C. Google Scholar
Instituição Universidade Federal de São Paulo (UNIFESP)
Resumo This is a roentgenographic and retrospective study comparing the results of two different operative procedures used in the treatment of Legg-Calve-Perthes disease: Satter innominate osteotomy, and Augmented Acetabuloplasty. Group I comprised 43 patients (50 hips) who underwent Salter osteotomy. Another 40 patients (40 hips) were treated by Augmented Acetabuloplasty and formed Group 2. in Group 1, 11 (25.58%) patients were girls and 32 (74.42%) were boys. in Group 2, there were 4 (10%) girl and 36 (90%) boy patients. the average age was 6.62 years in Group I and 6.35 years in Group 2. Follow-up varied from 2 years to 10 years in both Groups 1 and 2. in Group 1, 18 (36%) hips were in the stage of necrosis, 28 (56%) in fragmentation, and 4 (8%) in reossification; in Group 2, 16 (40%) hips were in necrosis, 23 (57.5%) in fragmentation, and only 1 (2.5%) in reossification. M hips in necrosis were included in Satter and Thompson group 13; all hips in fragmentation were classed as Catterall group 3 or 4. Preoperative arthrographs of the 50 hips in Group I were graded according to Laredo: 29 (58%) in group 111, 18 (36%) in group IV, and 3 (6%) in group V. Only 23 of the 43 hips of Group 2 had preoperative arthrographs; there were 14 (60.87%) in group 111, 8 (34.78%) in group IV, and 1 (4.35%) in group V. the preoperative Wiberg's Center-Edge (CE) angle of Group 2 (19.4degrees) was significantly greater than that of Group 1 (16.7degrees). the percentage difference (Delta%) between immediate postoperative and preoperative CE angle was significantly greater in Group 2. the Delta% between final and immediate postoperative CE angle was significantly greater in Group I, and within Group I it was significantly greater at age 4 years to 6 years. the Delta% between final and preoperative CE angle was statistically the same in both Group I and Group 2. the distribution of good, fair and poor Mose ratings did not differ in Group I and Group 2, but there was a tendency of better results after Augmented Acetabuloplasty in children older than 6 years. Younger patients of Group 1 (4-6 years) ended up with good results at a significantly higher frequency than the older ones. Group I children with preoperative Laredo III arthrography had good results in a significantly greater number of cases, as compared with Laredo grade IV. the Delta% between final and immediate postoperative CE angle was greater in those hips with good Mose rating. (C) 2002 Lippincott Williams Wilkins.
Palavra-chave Legg-Calve-Perthes disease
pelvic
osteotomy
roentgenographic
results
Idioma Inglês
Data de publicação 2002-01-01
Publicado em Journal of Pediatric Orthopaedics-part B. Philadelphia: Lippincott Williams & Wilkins, v. 11, n. 1, p. 15-28, 2002.
ISSN 1060-152X (Sherpa/Romeo, fator de impacto)
Publicador Lippincott Williams & Wilkins
Extensão 15-28
Fonte http://dx.doi.org/10.1097/00009957-200201000-00004
Direito de acesso Acesso restrito
Tipo Artigo
Web of Science WOS:000173892200004
Endereço permanente http://repositorio.unifesp.br/handle/11600/26720

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