SA Orthopaedic Journal
On-line version ISSN 2309-8309
SCHEPERS, A and ROBERTSON, AF. Legg-Calvé-Perthes disease: the results of a prospective clinical trial comparing the outcomes of surgery and symptomatic treatment for patients presenting at age 5 years or younger. SA orthop. j. [online]. 2011, vol.10, n.2, pp. 67-73. ISSN 2309-8309.
It is widely recommended that children with Legg-Calvé-Perthes (LCP) disease aged 5 years or younger be treated non-surgically. Studies have nevertheless shown that this group does not have a universally good outcome. A prospective clinical trial was started in 1978, using lateral subluxation (extrusion) of the femoral head in the fragmentation stage of the disease as an indication for surgery. A review of 71 patients with 73 involved hips treated at age 5 years or younger shows that children who present with a Catterall 4/Herring C classification, as well as the presence of lateral subluxation, do better following a Salter innominate osteotomy than a comparable group that was treated with intermittent analgesics, rest and physiotherapy.
Keywords : Perthes' disease; Salter osteotomy; age under 5 years; untreated controls; outcomes.