Abstract
We have been following all modern trends in the treatment of Legg-Calve-Perthes disease during several decades (from nonoperative treatment, revascularization procedures, varization femoral osteotomies to various pelvic osteotomies). Last few years we have started to use triple pelvic osteotomy in patients older than seven years, in order to shorten treatment period, establish solid containment and subsequent remodelation of femoral head, and achieve final spheric hip congruence.
In the period from 1996 to 2004 we had 28 such surgical interventions.
Patient age at surgery was between 7 and 10 years. All hips were uncontained preoperatively, and in fragmentation stage. Twelve hips were classified as Catterall group III and sixteen hips as Catterall group IV.
Triple pelvic osteotomy according to Tonnis (modified by Vladimirov) was performed in all cases.
Average follow-up period was 40 (28–96) months.
Treatment result was good in all patients, with full functional recovery.
Spheric joint congruence was achieved in 24, and aspheric congruence in other 4 cases.
Average period for union of osteotomies was 10 weeks, followed by introduction of full weight bearing, considerably earlier than in patients with similar age and disease stage, treated by combination of Salter pelvic osteotomy and femoral shortening.
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