Advertisement for orthosearch.org.uk
Results 1 - 2 of 2
Results per page:
The Journal of Bone & Joint Surgery British Volume
Vol. 85-B, Issue 1 | Pages 121 - 124
1 Jan 2003
Kitoh H Kitakoji T Katoh M Takamine Y

We studied radiographs of 125 children (105 boys, 20 girls) with unilateral Legg-Calvé-Perthes’ disease to examine the epiphyseal development of the femoral head in the contralateral (unaffected) hip. The epiphyseal height (EH) and width (EW) of the unaffected hip were measured on the initial anteroposterior pelvic radiograph.

In 109 of the patients (87.2%) the EH was below the mean for normal Japanese children and a significantly small EH (below −2 sds) was observed in 23 patients (18.4%). By contrast, the EW of most patients (95.2%) lay within ± 2 SDs of normal values except for six with a significantly small EW. A strong positive linear correlation (R = 0.87) was observed in the EH:EW ratio in the patients. A smaller EH than expected for EW in our series indicated epiphyseal flattening of the femoral head in Legg-Calvé-Perthes’ disease.

Our findings support the hypothesis that a delay in endochondral ossification in the proximal capital femoral epiphysis may be associated with the onset of Perthes’ disease.


The Journal of Bone & Joint Surgery British Volume
Vol. 81-B, Issue 3 | Pages 385 - 391
1 May 1999
Hattori T Ono Y Kitakoji T Takashi S Iwata H

We reviewed 98 children (133 hips) with developmental dysplasia of the hip who underwent arthrography immediately after closed reduction by overhead traction. We followed the patients to skeletal maturity to investigate whether soft-tissue interposition influences acetabular development and avascular necrosis over the long term.

The shape of the limbus and the thickness of the soft-tissue interposition at the acetabular floor, as shown on arthrograms at the time of reduction, were not directly related to the final radiological results or to the incidence of avascular necrosis. Even if marked soft-tissue interposition was found on the initial arthrogram, spontaneous disappearance was noted in 71% up to the age of five years. The final radiological results showed no difference between those in which the interposition disappeared and those with none at the time of closed reduction. However, the requirement for secondary surgery at the age of five years was significantly higher in those with more than 3.5 mm of soft-tissue interposition. In the no-disappearance group (group C) further operation was necessary in 100% and the results were significantly worse at maturity according to Severin’s classification.

We suggest that the indications for open reduction should not be based solely on the arthrographic findings at the time of closed reduction.