56 patients who had undergone lower limb lengthening in accordance with Ilizarov principles in 61 bone segments were retrospectively studied and functional outcomes were evaluated by 5 different assessment systems.

There were 17 cases of congenial bone deficiencies, 11 post poliomyelitis, 11 post traumatic, 8 post infection, and 9 miscellaneous cases.

The average lengthening was 7.6 centimeters (3–14). Among the 46 patients who had reached skeletal maturity at the time of study,79% had reached their lengthening goal. 10 patients had still open physes and would require further equalization procedures.

There were 40 side effects (complications and obstacles) and 37 problems. 27 cases required additional surgery to treat the complications. Major complications were most commonly seen in congenital femoral lengthening cases.

The functional outcome as evaluated by the five different assessment systems revealed improvement in almost all aspects. The improvement in esthetic appearance of the limb and shoe -wear, walking, sporting activities, and limp were the most common reasons for satisfaction as observed in 89% of the cases.

Purpose: Background: Treatment of Legg-Perthes disease in older children with greater involvement of the femoral head remains uncertain. Innominate or combined innominate and femoral osteotomies are generally performed to better contain and provide more coverage of the femoral head by the acetabulum and thus achieve a more spherical head and a congruent joint. The purpose of the study was to show the results of both surgeries.

Methods: We carried out a retrospective review of 43 hips in 41 patients (36 males, 5 females), with lateral pillar classifications of B (25 hips), B/C (12), and C (6), who had not responded to non-surgical treatment and all treated by one surgeon. They underwent Salter innominate (23 hips) or combined innominate and femoral osteotomies (20 hips). Mean age of the former group at surgery was 7 years, 11 months and of the latter, 10 years, 7 months. Combined osteotomy was performed in older children with more head involvement and stiff hips that did not respond to other treatments. Patients were evaluated with a mean follow-up of 9 years, 4 months using the Stulberg radiographic assessment.

Results: Results: Stulberg I or II (SI-SII) results were attained by 57% of the innominate osteotomy group and 30% of the combined. Eleven of 14 LPB hips in the innominate group and 5 of 11 in the combined became SI-II in contrast to 2 of 5 and 1 of 7 LPB/C hips, respectively. All 6 LPC hips were classified Stulberg III or IV (SIII-IV). Children younger than 8 years in the innominate group had better results than the older children (65% vs 33%) and those younger than 10 in the combined group did better than the older (43% vs 0%).

Conclusions: Conclusions: The LPB and LPB/C groups treated by innominate osteotomy had better results (more spherical heads) than those undergoing combined osteotomy, age proving a stronger prognostic factor than disease stage. The LPC led to aspherical congruent hips with either type of surgery, regardless of patient’s age. The outcome was better in LPB in children younger than 8 years of age and in LPB/C in those older than 8 years. Age of onset still remains the primary determinant of outcome in LCPD.