Valgus osteotomy for hinge abduction in Legg-Perthes’ disease: Decision-making and outcomes

Valgus osteotomy for hinge abduction in Legg-Perthes’ disease: Decision-making and outcomes

Yoo, Won Joon

PERTHES DISEASE & SLIPPED UPPER FEMORAL EPIPHYSIS

We evaluated growth and remodeling of the 21 hips after valgus osteotomy with rotational and sagittal components for hinge abduction in 21 patients (mean, 9.7 years) with Legg-Calve-Perthes disease (LCPD) both clinically and radiologically. The type of osteotomy was determined by assessing the hinge movement three-dimensionally using preoperative gait assessment, 2-dimensional/3-dimensional computed tomography (2D/3D-CT). and intraoperative dynamic arthrography. The Iowa hip score averaged 66 (34 to 76) before operation and 92 (80 to 100) at a mean follow-up of 7.1 years (3.0 to 15.0). Radiographie measurements revealed favorable remodeling of the femoral head and improved hip joint mechanics. Valgus osteotomy with rotational and sagittal components results in sustained improvement in symptoms and functions and beneficially influences remodeling of the hip.

Preoperative gait assessment, 2D/3D-CT, and intraoperative dynamic arthrography are helpful for assessing the spatial features of the femoral capital hump and for determining the optimal congruent position of the hip.

Choi, In Ho., Won Joon Yoo, Chin Youb Chung, Tae-Joon Cho.

Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea

Copyright British Editorial Society of Bone & Joint Surgery 2003

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