Early Outcomes Evaluation Of Proximal Femoral Varus Osteotomy Combined With Salter Innominate Osteotomy For The Treatment Of Perthes Disease

Objective To evaluate the early outcomes of proximal femoral varus osteotomy combined with Salter innominate osteotomy for the treatment of Perthes disease.Methods The basic data of children with Perthes disease treated with proximal femoral varus osteotomy combined with Salter innominate osteotomy in our hospital from August 2011 to August 2014 were collected.To compare the clinical symptoms,hip joint activity,acetabular index(AI),femoral head epiphyseal extrusion indice,center edge angle(CEA)of these children before operation and at the end of the follow-up.We assessed the function of the affected side of the hip joint function according to Mckay classification criteria,and evaluated the prognosis of patients according to the modified Stulberg classification criteria depending on the results of the image at final follow-up.Results There were 27 cases in total,23 cases were followed up,including 19 males and 4 females,13 cases of left hip and 10 cases of right hip.According to Herring classification,type B 9 cases,type B/C 4 cases,type C 10cases;according to Catterall classification,type III in 11 cases,type IV in 12 cases.The mean age at the time of surgery was 8 years and 5 months old(range:6 years-12 years and 2 months old),the average follow-up was 39months(range:26-67 months).The preoperative and the last follow-up mean acetabular indexes(AI)were as follows:(21.87±4.69)°and(13.36±2.21)°,and the average of femoral head epiphyseal extrusion indices were30.25±7.75)%and(10.72±10.26)%,the center edge angles(CEA)were(23.11±7.08)°and(38.01±6.38)°,The differences between them were statistically significant(P<0.000)。According to Mckay classification criteria,the excellent rate was 87%;according to the modified Stulberg criteria,hip acetabular adaptation rate was 91.3%.Conclusion Proximal femoral varus osteotomy combined with Salter innominate osteotomy for the treatment of Perthes disease can significantly improve hip femoral head containment and hip function.The recent early outcomes are satisfied.