Abstract
The best method of femoral head containment in Legg-Calvé-Perthes’ disease (LCPD) is still controversial. Triple pelvic osteotomy allows desired rotation of acetabulum, reduces the relative stress, provides optimum femoral head cover and compensates for shortening. The iliac osteotomy was modified to interlock following acetabular rotation to provide extra stability and allow early mobilisation.
Material and methods: We reviewed 21 patients, who underwent interlocking triple pelvic osteotomy for severe Legg-Calvé-Perthes’ disease, to evaluate their clinical, radiological and functional results.
The mean patient age at presentation was 7 years and 7 months. Fourteen hips were in the fragmentation stage whereas 8 were in the early re-ossification stage. Seventeen hips were Herring group C and 5 were group B. Seventeen hips had 2 or more at risk radiological signs. The average period of follow-up was 51 months (range, 33 months to 80 months). The average gain in acetabular head index was 18% and that in centre-edge angle was 22 degrees, more than reported for any other single surgical procedure. According to the Harris hip rating system, there was an average gain of 35 points. Average gains in abduction, internal rotation and flexion were 17, 12 and 28 degrees respectively. The average gain in length of the limb was 6.4 mm.
Interlocking triple pelvic osteotomy in LCPD provides good cover of the femoral head, good symptom relief and markedly improved range of motion. Assessment of a few patients approaching maturity has shown a congruent hip joint with a spherical femoral head.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
