CHANGES OF THE HIP IN PERTHES’ DISEASE WITH AN EXTENSIVE LESION AFTER ROTATIONAL OPEN WEDGE OSTEOTOMY

Abstract

Introduction: We performed rotational open wedge osteotomy ( ROWO ) for Perthes’ disease with an extensive lesion. With this technique, the femoral head was rotated anteriorly, the postero-lateral viable segment was moved below the lateral acetabular roof consequently with the intertrochanteric osteotomy. We reviewed the results of this procedure radiographically.

Materials and Methods: Twenty two cases over 2 years follow up were investigated. Nineteen hips (19 patients) were boys and 3 hips (3 patients) were girls. The patients’ mean age at the time of the operation was 7 years and 9 months and the mean follow-up was 6.5 years. There were 15 hips in fragmentation stage and 7 hips in healing stage. In Catterall Grouping, 19 hips were in Group III and 3 hips were in Group IV. The mean rotation angle was 36 degrees, and the mean varus angle was 21 degrees. We analyzed Stulberg classification and Mose’ rating at the final X-ray.

Results By the Stulberg classification on final X-ray, 3 hips were in class I, 17 hips were in class II, 2 hips were in class III, and class IV and V were not seen. In Mose’ rating, all cases had good or fair results.

Discussion: We conclude that rotational open wedge osteotomy is a beneficial procedure for Perthes’ disease with extensive lesions.