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Title:
Comparison between conservative and surgical treatment of Perthes' disease
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Subject:
functional neck-shaft angle ; Perthes' disease ; 3DCT ; Salter innominate osteotomy ; functional angle of antetorsion
Abstract:
Perthes disease is one of the most frequent disorders of the hip in adolescent and is the most frequent aseptic necrosis among children and young adults. Etiology of the disease is still unclear. Conservative as well as surgical procedures aim to obtain a spherical femur head entirely covered by the acetabulum, what in future prevents degenerative changes of the hip joint. Among surgical methods two groups can be distinguished: intratrochanteric osteotomies and acetabuloplastics. In this paper the applicability of treatment of Perthes disease with hip osteotomy by Salter compared to conservative treatment based on radiological and computer tomography analysis by Kim and Wenger is evaluated. 102 patients with unilateral Perthes disease treated surgically were evaluated. Control group consisted of 102 patients with unilateral Perthes disease treated conservatively. Staging of the disease was evaluated basing on Catterall classification. In radiological examination the shape of the femur head by Mose, the Wiberg angle, the height of the greater trochanter and the lateralization of the femur head were assessed. In computer tomography the anatomical and functional angles of antetorsion, the neck-shaft angle and the Wiberg in MPR angle were analyzed. The final outcome of treatment was based on modified classification of Stulberg-Herring. Statistical analysis did not report any d ; ifference between treatment methods despite individual better results in the surgically treated group. Surgical technique is a beneficial treating method, which guarantees over 81 % of positive results and is less troublesome that conservative treatment.
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choroby narządów ruchu ; pediatria