Valgus Femoral Osteotomy is Treatment Option for Late Hinge Abduction in Legg-Calve-Perthes Disease
When a patient presents with Legg-Calve-Perthes disease, the main objective is to minimize damage to the hip joint. However, some patients present with hinge abduction (abnormal hip movement) that can occur when the femoral head (ball part of the hip joint) is deformed. When this happens, the goal is to reduce this and minimize pain.
The authors of this study researched earlier trials to evaluate if surgery, called valgus osteotomy, is appropriate for patents in their late teens.
Fifteen patients, 13 males, who had undergone surgery were identified for this study. The patients were a mean age of 17 years and 9 months at the time of their surgery (ages ranging from 11 to 32 years and 6 months). Assessment before surgery included x-rays, including some while the patients were under anesthesia, an arthrogram (air or dye injected into the joints for x-ray), the Harris Hip Score, and assessment of range of motion and leg length differences.
After surgery, all patients were followed in the clinic for at least six months to ensure that the surgery was successful, and further follow-up was done by telephone.
The researchers found that the HHS score, which was initially a mean of 48 out of 100 (100 being the best possible score) before surgery was now reported at a mean of 89. In range of motion, there was a mean improvement from before surgery of 15 degrees. Fourteen of the 15 patients had improvements in the leg length difference. All x-rays showed union of the bones, and up to two years of follow-up did not show any significant changes in the hip.
The valgus osteotomy, used for hinge abduction, appears to be an effective treatment in this age group, the authors of this study concluded.
References: Graham J.C. Myers, FRCS, Keshav Mathur, FRCS, and John O'Hara, FRCS. Valgus Osteotomy. A Solution for Late Presentation of Hinge Abduction in Legg-Calve-Perthes Disease. In Journal of Pediatric Orthopaedics. March 2008. Vol. 28, No. 2. Pp. 169-172.
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