A Comparative Analysis Of The Therapeutic Effect Of Greater Trochanteric Epiphysiodesis On The Children With Legg-Calve-Perthes Disease

Objective: To evaluate the effect of greater trochanteric epiphysiodesis(GTE)for Legg-Calve-Perthes Disease(LCPD)in children.Methods: A total of 78 patients with LCPD treated by surgery in our hospital from Jan.2013 to Jun.2019 were included in the study.They were divided into the risk sign group and the no risk sign group according to that if there were radiographic risk signs of overgrowth of the greater trochanter(OGGT)on X-ray films,while the patients in risk sign group were divided into the GTE group and the non-GTE group according to different surgical procedures.the GTE group was treated with inclusive surgery combined with GTE including 14 cases(16 hips),and the non-GTE group(33 cases,33 hips),was only treated with inclusive surgery.There were 31 cases and31 hips in the no risk sign group.The above cases were followed up on clinical symptoms and radiographic data.Results: In the follow-up term,patients ranged 12 to 89 months(mean,30.6 months).The rate of OGGT in the non-GTE group(75.8%)was significantly higher than the no risk sign group(6.5%)(P<0.001),and the rate of OGGT in the GTE group(21.4%)was significantly lower than the non-GTE group(75.8%)(P=0.001).According to the comparative analysis of the development of the greater trochanter between the affected side and the healthy side in the GTE group,the growth of the greater trochanter that underwent GTE was inhibited by 1.32 mm/year,while greater inhibition(1.77 mm/year)was noted in children who underwent the hollow nail epiphysiodesis.The clinical effect in the GTE group was also better than the non-GTE group.Conclusion: Radiographic risk signs of OGGT have definite predictive significance and can be the indication for GTE,and selective GTE can effectively inhibit the growth of greater trochanter and avoid OGGT.Combined with traditional inclusive surgery,the therapeutic effect can be improved.