Kołban Maciej, Darczuk Jadwiga, Chmielnicki Michał
Katedra i Klinika Ortopedii Dzieciecej PAM, Szczecin.
Ortop Traumatol Rehabil. 2004 Nov-Dec;6(6):705-11.
Background. Despite extensive research, it is still unknown whether a 40% increase in the anteversion angle value is a primary or a secondary change in Perthes' disease. The aim of the study was to evaluate the variability of the anteversion angle in children with unilateral Perthes disease treated operatively with varus and derotation osteotomy. Material and methods. 53 patients between 5 and 10 years were included in this study. The stage and type of necrosis were classified using radiological examination according to the Reiberg and Cattarall classification. The value of anteversion was determined using clinical and ultrasound examination in addition to directly during surgery. After the operation, the anteversion angle was 11 degrees . During a 6-year follow-up period, ultrasound examination was performed every 12 months. Angle values obtained through direct measurements were compared with the norms published by Lanz and Wachsmuth, and ultrasound measurements were compared with the norms for the age groups. Results. 47 patients were found to be in stage III of the disease and 6 were in stage II. During the period up to 36 months after surgery, the value of the anteversion angle gradually reached the same value as in a limb considered as "healthy". During the following 36 months these values remained unchanged. Conclusions. An increased value of the anteversion angle in children with Perthes' disease is observed in a limb considered as "healthy". An increased value of the anteversion angle in children with Perthes' disease is a secondary deformation caused by the arrest of the physiological decrease of its value during development.
背景。尽管进行了广泛研究，但佩特兹病前倾角度值增加40%是原发性还是继发性改变仍不清楚。本研究的目的是评估接受内翻和去旋转截骨术手术治疗的单侧佩特兹病患儿前倾角度的变异性。材料与方法。本研究纳入了53例5至10岁的患者。根据赖伯格和卡塔拉分类法，通过放射学检查对坏死的阶段和类型进行分类。除了在手术过程中直接测量外，还通过临床和超声检查确定前倾值。术后，前倾角度为11度。在6年的随访期内，每12个月进行一次超声检查。将直接测量获得的角度值与兰茨和瓦克斯穆特公布的标准进行比较，将超声测量值与各年龄组的标准进行比较。结果。发现47例患者处于疾病III期，6例处于II期。在术后长达36个月的期间内，前倾角度值逐渐达到与被视为“健康”肢体相同的值。在接下来的36个月中，这些值保持不变。结论。在被视为“健康”的肢体中观察到佩特兹病患儿前倾角度值增加。佩特兹病患儿前倾角度值增加是发育过程中其值生理性下降停滞导致的继发性变形。
