PROXIMAL FEMORAL VARUS OSTEOTOMY FOR PERTHES DISEASE

Abstract

Purpose: The purpose of this study is to evaluate the results of patients treated with proximal femoral varus osteotomy for Perthes disease.
Patients and methods: This operation was performed on 13 patients in the 2nd Orthopaedic Clinic of Ministry of Health Ankara Hospital, between October 93 and December 96. Average age of patients at the time of operation was 7.9 years (range, 6 to 11 years), male to female ratio was 11/2. Average follow up was 21,3 months (range, 11 to 34 months). The results were evaluated by "lowa Hip Rating" criteria's.
Results: Preoperatively the mean epiphyseal extrusion was 18.1% (range, 10.4% to 28.3%) and mean Wiberg's CE angle was 24.7° (range, 20.3° to 30.2°). In the last follow-up examinations the mean values were 9.5% (range, 7.4% to 16.7%) and 34.1° (range, 27.3° to 38.5°) respectively. Preoperatively, the mean collo-diaphyseal angle was 133.5°, that decreased to 118.4° at the final follow-up. According to the "lowa Hip Rating" the results were successful in 7 (54%) patients, moderately successful in 4 (31%) patients and unsuccessful in 2 (15%) patients. One of the patients in the bad result group was 11 years old and the other was 10 years old and both of them were in Catterall Group IV.
Conclusion: Best results with proximal femoral varus osteotomy can be obtained in children without any femoral head deformity and flattening, with good containment in abduction and internal rotation and in children between the ages of 6-10 years.