Pelviv Triad-Osteotomy In The Treatnent Of Perthes Disease In The Children

BackgroundLegg-Calvé-Perthes disease (LCPD) is an avascular necrosis of the femoral head in children.It is the self-cure and self-limited disease.It betide to children of the age of 2 to 14 years.Mostly on the age of 4 to 10 years.The male female ratio is 4-5:1,the half hip occupy 90%,it is one of the most common and considerable femoral articulation disease.Because of the etiology and pathological change unknown,so that the evidence of treatment is default,the curative effect are not satisfactory.The goals of treatment are to lighten the clinical symptom,to improve the joint function of the hip, to prevent the pathological changes become more serious,make the femoral head to obtain the favourable contain and get the biology moulding,to prevent the scaphocephaly of the femoral head and degenerative arthritis.Pelvic triad-osteotomy through to cut of upper and inferior branch of the pubic bone and the superior border of acetabular bone,make the acetabular bone forward and outward to revolve, improved the coverage areas of the necrosis femoral head, make the femoral head to obtain the favourable contain and get the biology moulding. So that the disease can be get the faster recuperation,and prevent the scaphocephaly and osteoarthritis of the femoral head.ObjectiveTo discuss the therapeutic effect of pelvic triad-osteotomy for perthes'disease in children.MethodsThirty-four patients with Perthes disease were treated by pelvic triad-osteotomy.The series consistsed of 28 boys and 6 girls(right 15 cases,left 19 cases).According to Catterall's classification,2 cases were graded as groupⅡ, 23 cases were graded as groupⅢ, 9 cases were graded as groupⅣ.The mean age of patients was eight years and nine months at operation.ResultsAll patients were successfully followed up for a period from 24 to 54 months(the mean of 30 months ),and were assessed clinically with Mckay Criteria and radiologically with Willett assessment.The clinical rusults showed that 25 are excellent(the rate was73.53%),7 are good(the rate was 20.59%)and 2 are acceptable(the rate was 5.88%),the overall excellent or good rate was 94.12%.The radiologically results showed that the epiphyseal high,percentage of acetabular cover and center edge angle significantly increased (P<0.001),Sharp angle significantly decreased(P<0.01),the continuity of Shenton's line and the form of femoral head was obviously improve.ConclusionsPelvic triad-osteotomy could keep sphericity of the femoral head and congruity with acetabulum of the hip for children with Legg–Perthes disease. And also could be in aid of preventing premature arthritis of hip.It should be an effective procedure for treating Perthes disease in children. And be used in the clinical practice.