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Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease

BACKGROUND: Perthes disease is a condition in which a self-limiting avascular event affects the capital epiphysis of the femur with a very variable course. It has been shown frequently, however, that there is a group of patients who definitely benefit from containment, either surgical or nonsurgical...

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Autores principales: Mohan Kumar, E G, Yathisha Kumar, G M, Rasheed, M Abdul
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241054/
https://www.ncbi.nlm.nih.gov/pubmed/30532302
http://dx.doi.org/10.4103/ortho.IJOrtho_47_17
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author Mohan Kumar, E G
Yathisha Kumar, G M
Rasheed, M Abdul
author_facet Mohan Kumar, E G
Yathisha Kumar, G M
Rasheed, M Abdul
author_sort Mohan Kumar, E G
collection PubMed
description BACKGROUND: Perthes disease is a condition in which a self-limiting avascular event affects the capital epiphysis of the femur with a very variable course. It has been shown frequently, however, that there is a group of patients who definitely benefit from containment, either surgical or nonsurgical, better with surgical. We studied midterm to long term outcome of closed wedge varus derotation osteotomy (VDRO) with trochanteric apophysiodesis in Perthes disease. MATERIALS AND METHODS: 88 children with mean age of 7.9 ± 2 years, belonging to Herring's lateral pillar Groups B and C treated with VDRO with trochanteric apophysiodesis were included in this study. Radiological evaluation was done using Mose's index, the epiphyseal quotient, the articulotrochanteric distance and center edge angle of Wiberg. RESULTS: Containment was achieved in all patients on postoperative radiographs. At a mean followup of 12 years, good results were obtained in 66, fair in 19, and poor in 3 patients using Catterall's postoperative classification. CONCLUSIONS: VDRO is an effective containment method of femoral head for patients belonging to the Herring's Group B and also effective in many patients belonging to Herring's Group C. It is a good procedure to attain containment in children <9 years of age. Trochanteric apophysiodesis reduces risk of limping.
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spelling pubmed-62410542018-12-10 Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease Mohan Kumar, E G Yathisha Kumar, G M Rasheed, M Abdul Indian J Orthop Original Article BACKGROUND: Perthes disease is a condition in which a self-limiting avascular event affects the capital epiphysis of the femur with a very variable course. It has been shown frequently, however, that there is a group of patients who definitely benefit from containment, either surgical or nonsurgical, better with surgical. We studied midterm to long term outcome of closed wedge varus derotation osteotomy (VDRO) with trochanteric apophysiodesis in Perthes disease. MATERIALS AND METHODS: 88 children with mean age of 7.9 ± 2 years, belonging to Herring's lateral pillar Groups B and C treated with VDRO with trochanteric apophysiodesis were included in this study. Radiological evaluation was done using Mose's index, the epiphyseal quotient, the articulotrochanteric distance and center edge angle of Wiberg. RESULTS: Containment was achieved in all patients on postoperative radiographs. At a mean followup of 12 years, good results were obtained in 66, fair in 19, and poor in 3 patients using Catterall's postoperative classification. CONCLUSIONS: VDRO is an effective containment method of femoral head for patients belonging to the Herring's Group B and also effective in many patients belonging to Herring's Group C. It is a good procedure to attain containment in children <9 years of age. Trochanteric apophysiodesis reduces risk of limping. Medknow Publications & Media Pvt Ltd 2018 /pmc/articles/PMC6241054/ /pubmed/30532302 http://dx.doi.org/10.4103/ortho.IJOrtho_47_17 Text en Copyright: © 2018 Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Mohan Kumar, E G
Yathisha Kumar, G M
Rasheed, M Abdul
Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title_full Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title_fullStr Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title_full_unstemmed Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title_short Outcome of Closed Wedge Varus Derotation Osteotomy with Trochanteric Apophysiodesis in Perthes Disease
title_sort outcome of closed wedge varus derotation osteotomy with trochanteric apophysiodesis in perthes disease
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6241054/
https://www.ncbi.nlm.nih.gov/pubmed/30532302
http://dx.doi.org/10.4103/ortho.IJOrtho_47_17
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