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Erschienen in: International Orthopaedics 5/2009

01.10.2009 | Original Paper

Triple pelvic osteotomy in the treatment of Legg-Calve-Perthes disease

verfasst von: Zoran Vukasinovic, Dusko Spasovski, Cedomir Vucetic, Goran Cobeljic, Zorica Zivkovic, Dragana Matanovic

Erschienen in: International Orthopaedics | Ausgabe 5/2009

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Abstract

This article presents the results of Legg-Calve-Perthes (LCP) disease treatment using triple pelvic osteotomy. Thirty patients were analysed. The conditions for inclusion in the study were complete medical documentation and follow-up until the disease was resolved. Postoperatively, no patients were immobilised. Rehabilitation was initiated early in all patients, and full weight bearing was allowed after ten weeks. With this method, an increase of the CE angle of 17.43 ± 4.020° was achieved. Containment was increased from an initial 6.67% to 53.33% of patients at the final check-up. Similar improvement was achieved by using Herring classification of the damage; preoperatively most hips belonged to group C, and postoperatively to group A. Postoperatively, functional results were also considerably improved. The authors recommend triple pelvic osteotomy as the method of choice in the treatment of severe cases of LCP disease.
Literatur
1.
Zurück zum Zitat Carlioz H (2000) Pelvic osteotomies in children and adolescents. Acta Orthop Belg 66:321–328PubMed Carlioz H (2000) Pelvic osteotomies in children and adolescents. Acta Orthop Belg 66:321–328PubMed
2.
Zurück zum Zitat Catterall A (1981) Legg-Calve-Perthes syndrome. Clin Orthop Relat Res 158:41–52PubMed Catterall A (1981) Legg-Calve-Perthes syndrome. Clin Orthop Relat Res 158:41–52PubMed
3.
Zurück zum Zitat Clohisy JC, Nunley RM, Curry MC, Schoenecker PL (2007) Pariacetabular osteotomy for the treatment of acetabular dysplasia associated with major aspherical femoral head deformities. J Bone Joint Surg Am 89:1417–1423PubMedCrossRef Clohisy JC, Nunley RM, Curry MC, Schoenecker PL (2007) Pariacetabular osteotomy for the treatment of acetabular dysplasia associated with major aspherical femoral head deformities. J Bone Joint Surg Am 89:1417–1423PubMedCrossRef
4.
Zurück zum Zitat Dal Monte A, Sonicini G, Valdiserri L (1980) Acetabuloplasty by triple pelvic osteotomy: indications and surgical technique. Ital J Orthop Traumatol 6:5–18PubMed Dal Monte A, Sonicini G, Valdiserri L (1980) Acetabuloplasty by triple pelvic osteotomy: indications and surgical technique. Ital J Orthop Traumatol 6:5–18PubMed
5.
Zurück zum Zitat Dogan A, Zorer G, Ozer UE (2007) Treatment of acetabular dysplasia by triple pelvic osteotomy and its short-term results. Acta Orthop Traumatol Turc 41:355–366PubMed Dogan A, Zorer G, Ozer UE (2007) Treatment of acetabular dysplasia by triple pelvic osteotomy and its short-term results. Acta Orthop Traumatol Turc 41:355–366PubMed
6.
Zurück zum Zitat Frick SL, Kim SS, Wenger DR (2000) Pre-and postoperative three-dimensional computed tomography analysis of triple innominate osteotomy for hip dysplasia. J Pediatr Orthop 20:116–123PubMedCrossRef Frick SL, Kim SS, Wenger DR (2000) Pre-and postoperative three-dimensional computed tomography analysis of triple innominate osteotomy for hip dysplasia. J Pediatr Orthop 20:116–123PubMedCrossRef
7.
Zurück zum Zitat Grzegorzewski A, Bowen JR, Guille JT, Gluttung J (2003) Treatment of the collapsed femoral head by containment in Legg-Calve-Perthes disease. J Pediatr Orthop 23:15–19PubMedCrossRef Grzegorzewski A, Bowen JR, Guille JT, Gluttung J (2003) Treatment of the collapsed femoral head by containment in Legg-Calve-Perthes disease. J Pediatr Orthop 23:15–19PubMedCrossRef
8.
Zurück zum Zitat Guille JT, Forlin E, Kumar SJ, MacEwen GD (1992) Triple osteotomy of the innominate bone in treatment of developmental dysplasia of the hip. J Pediatr Orthop 12:718–721PubMed Guille JT, Forlin E, Kumar SJ, MacEwen GD (1992) Triple osteotomy of the innominate bone in treatment of developmental dysplasia of the hip. J Pediatr Orthop 12:718–721PubMed
9.
Zurück zum Zitat Hailer NP, Soykaner L, Ackermann H, Rittmeister M (2005) Triple osteotomy of the pelvis for acetabular dysplasia: age at operation and the incidence of nonunions and other complications influence outcome. J Bone Joint Surg Br 87:1622–1626PubMedCrossRef Hailer NP, Soykaner L, Ackermann H, Rittmeister M (2005) Triple osteotomy of the pelvis for acetabular dysplasia: age at operation and the incidence of nonunions and other complications influence outcome. J Bone Joint Surg Br 87:1622–1626PubMedCrossRef
10.
Zurück zum Zitat Harris WH (2001) My first 50 years of orthopeadic surgery. J Arthroplasty 16(8 Suppl 1):2–7PubMedCrossRef Harris WH (2001) My first 50 years of orthopeadic surgery. J Arthroplasty 16(8 Suppl 1):2–7PubMedCrossRef
11.
Zurück zum Zitat Hefti F, Clarke NMP (2007) The management of Legg-Calve-Perthes disease: is there a consensus? J Child Orthop 1:19–25PubMedCrossRef Hefti F, Clarke NMP (2007) The management of Legg-Calve-Perthes disease: is there a consensus? J Child Orthop 1:19–25PubMedCrossRef
12.
Zurück zum Zitat Herring JA, Kim HT, Browne R (2004) Legg-Calve-Perthes disease. Part I: classification of radiographs with use of the modified lateral pillar and Stulberg classifications. J Bone Joint Surg Am 86:2103–2120PubMed Herring JA, Kim HT, Browne R (2004) Legg-Calve-Perthes disease. Part I: classification of radiographs with use of the modified lateral pillar and Stulberg classifications. J Bone Joint Surg Am 86:2103–2120PubMed
13.
Zurück zum Zitat Herring JA, Kim HT, Browne R (2004) Legg-Calve-Perthes Disease. Part II: prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg Am 86:2121–2134PubMed Herring JA, Kim HT, Browne R (2004) Legg-Calve-Perthes Disease. Part II: prospective multicenter study of the effect of treatment on outcome. J Bone Joint Surg Am 86:2121–2134PubMed
14.
Zurück zum Zitat Huang MJ, Huang SC (1999) Surgical treatment of severe Perthes disease: comparison of triple osteotomy and shelf augmentation. J Formos Med Assoc 98:183–189PubMed Huang MJ, Huang SC (1999) Surgical treatment of severe Perthes disease: comparison of triple osteotomy and shelf augmentation. J Formos Med Assoc 98:183–189PubMed
15.
Zurück zum Zitat Jawish R, Ghorayeb J, Khalife R (2007) Quadruple and juxta-articular pelvic osteotomy in children using anterior approach: technique and results. J Pediatr Orthop B 16:10–15PubMed Jawish R, Ghorayeb J, Khalife R (2007) Quadruple and juxta-articular pelvic osteotomy in children using anterior approach: technique and results. J Pediatr Orthop B 16:10–15PubMed
16.
Zurück zum Zitat Kirschner S, Raab P, Wild A, Krauspe R (2002) Clinical and radiological short-and mid-term results of triple pelvic osteotomy according to Tonnis in adolescents and adults. Z Orthop Ihre Grenzgeb 140:523–526PubMedCrossRef Kirschner S, Raab P, Wild A, Krauspe R (2002) Clinical and radiological short-and mid-term results of triple pelvic osteotomy according to Tonnis in adolescents and adults. Z Orthop Ihre Grenzgeb 140:523–526PubMedCrossRef
17.
Zurück zum Zitat Kumar D, Bache CE, O’Hara JN (2002) Interlocking triple pelvic osteotomy in severe Legg-Calve-Perthes Disease. J Pediatr Orthop 22:464–470PubMedCrossRef Kumar D, Bache CE, O’Hara JN (2002) Interlocking triple pelvic osteotomy in severe Legg-Calve-Perthes Disease. J Pediatr Orthop 22:464–470PubMedCrossRef
18.
Zurück zum Zitat Lin CJ, Huang SC, Liu TK (1992) Surgical treatment for Perthes disease at risk. J Formos Med Assoc 91:424–431PubMed Lin CJ, Huang SC, Liu TK (1992) Surgical treatment for Perthes disease at risk. J Formos Med Assoc 91:424–431PubMed
19.
Zurück zum Zitat Lipton GE, Bowen JR (2005) A new modified technique of triple osteotomy of the innominate bone for acetabular dysplasia. Clin Orthop Relat Res 434:78–85PubMedCrossRef Lipton GE, Bowen JR (2005) A new modified technique of triple osteotomy of the innominate bone for acetabular dysplasia. Clin Orthop Relat Res 434:78–85PubMedCrossRef
20.
Zurück zum Zitat Poul J, Vejrostova M (2001) Triple osteotomy of the pelvis in children and adolescents. Acta Chir Orthop Traumatol Cech 68:93–98PubMed Poul J, Vejrostova M (2001) Triple osteotomy of the pelvis in children and adolescents. Acta Chir Orthop Traumatol Cech 68:93–98PubMed
21.
Zurück zum Zitat Stulberg SD, Cooperman DR, Wallensten R (1981) The natural history of Legg-Calve-Perthes disease. J Bone Joint Surg Am 63:1095–1108PubMed Stulberg SD, Cooperman DR, Wallensten R (1981) The natural history of Legg-Calve-Perthes disease. J Bone Joint Surg Am 63:1095–1108PubMed
22.
Zurück zum Zitat Tschauner C, Sylkin A, Hofmann S, Graf R (2003) Painful nonunion after triple pelvic osteotomy. Report of five cases. J Bone Joint Surg Br 85:953–955PubMedCrossRef Tschauner C, Sylkin A, Hofmann S, Graf R (2003) Painful nonunion after triple pelvic osteotomy. Report of five cases. J Bone Joint Surg Br 85:953–955PubMedCrossRef
23.
Zurück zum Zitat Von Bremen-Kuhne R, Vega-Salgado H, Steffen R (2006) Triple pelvic osteotomy (according to Tonnis and Kalchschmidt) in the treatment of acetabular dysplasia-medium-term results. Z Orthop Ihre Grenzgeb 144:484–491CrossRef Von Bremen-Kuhne R, Vega-Salgado H, Steffen R (2006) Triple pelvic osteotomy (according to Tonnis and Kalchschmidt) in the treatment of acetabular dysplasia-medium-term results. Z Orthop Ihre Grenzgeb 144:484–491CrossRef
24.
Zurück zum Zitat Vukašinović Z, Slavković S, Miličković S, Siqeca A (2000) Combined Salter innominate osteotomy with femoral shortening versus other methods of treatment for Legg-Calve-Perthes disease. J Pediatr Orthop B 9:28–33PubMed Vukašinović Z, Slavković S, Miličković S, Siqeca A (2000) Combined Salter innominate osteotomy with femoral shortening versus other methods of treatment for Legg-Calve-Perthes disease. J Pediatr Orthop B 9:28–33PubMed
25.
Zurück zum Zitat Vukašinović Z, Spasovski D (2006) Triple pelvic osteotomy-complications and how to avoid them. Srp Arh Celok Lek 134:49–53PubMedCrossRef Vukašinović Z, Spasovski D (2006) Triple pelvic osteotomy-complications and how to avoid them. Srp Arh Celok Lek 134:49–53PubMedCrossRef
Metadaten
Titel
Triple pelvic osteotomy in the treatment of Legg-Calve-Perthes disease
verfasst von
Zoran Vukasinovic
Dusko Spasovski
Cedomir Vucetic
Goran Cobeljic
Zorica Zivkovic
Dragana Matanovic
Publikationsdatum
01.10.2009
Verlag
Springer-Verlag
Erschienen in
International Orthopaedics / Ausgabe 5/2009
Print ISSN: 0341-2695
Elektronische ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-009-0745-x

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