Early Radiological Efficacy Evaluation And Prognosis Analysis Of Conservative Treatment Of Legg-Calve-Perthes Disease

Objective:In this study,patients with Legg-Calvé-Perthes disease treated conservatively were taken as the research object.By analyzing relevant data of patients with Perthes disease included in the study,the early radiographic effects of conservative treatment of Perthes disease and related factors affecting treatment outcome were evaluated.Methods:A retrospective analysis of 35 cases of Perthes disease in our hospital from January 2010 to December 2018 through abduction brace combined with conservative treatment of non-weight bearing hip joints activity training in our hospital,the patients including 29 males,6females,which include 17 left hips,and 18 right hips,mean age(5.33 ±1.85)years(2.12-10.17).Age at the beginning of treatment and gender the lateral patellar classification,Catterall classification,SFR,FHC,EI,EQ at prognosis at the stage of fragmentation was analyzed;According to the final follow-up X-ray,the modified Stulberg classification was used as an parameter for judging the prognosis.Result:(1)All 35 patients were followed up to the stage of residual withan average follow-up time of(41.60 ± 12.8)months(21-86);The final of modified Stulberg classification evaluation shows: excellent in 18 cases,good in 14 cases,and poor in 3 cases;Fisher's exact test assessed categorical variables showing that the lateral patellar type(P = 0.003)was associated with the prognosis of conservative treatment of perthes disease;Spearman correlation analysis evaluated continuous variables shows that age(P = 0.003)and epiphyseal quotient(P = 0.042)were correlated with the prognosis of conservative treatment of perthes disease;(2)Logistic regression analysis showed that lateral patellar classification(P = 0.005),epiphyseal quotient(P = 0.011),age(P =0.005)and femoral head coverage(P = 0.021)were independent risk factors for conservative treatment of Perthes disease;(3)The ROC curve demonstrate that when age is less than 5.90 years and the epiphyseal quotient is greater than 0.58,patients often have better prognosis;Conclusion:(1)Most children with Perthes disease treated conservatively can restore the spherical contour of the femoral head and achieve better acetabular match relationship.(2)The prognosis is closely related to age,EQ,lateral patellar classification and FHC.When age of onset is less than 5.90 years,most patients with lateral patellar classification a,b,and EQ are greater than0.58 have good early prognosis.(3)It may be better to choose whether conservative treatment or surgical treatment depends on age,EQ,lateral patellar type,and acetabular coverage.