Kiepurska A
Department of Orthopaedics, Postgraduate Medical Education Academy, Otwock, Poland.
Clin Orthop Relat Res. 1991 Nov(272):76-81.
Two hundred ninety-six cases of Perthes' disease with 334 affected hips (38 children had bilateral involvement) were treated by the principle of containment in a "broomstick cast" in abduction and internal rotation, preserved motion in the hip, and continuous traction. Prognostic indicators were recorded, including the age at the onset of the disease, Catterall Group, and risk factors. The mean follow-up period was 8.6 years. The average age at the last examination was 14.1 years (range, six to 25 years). The end results of the treatment were evaluated roentgenographically by the Heyman and Herndon method of quotients. In these 334 treated hips, the results were very good in 216 cases and good in 92 cases (92% very good and good combined), whereas in 23 cases, results were fair and in three, poor (8% fair and poor combined). The results were dependent on the age at the time of diagnosis, the degree of femoral head involvement, and presence of "head at risk," particularly femoral subluxation. The fair and poor results were found in children older than nine years of age, with total head involvement, crushing epiphysis, and presence of risk factors. The results in this study suggest the superiority of treatment in Perthes' disease by a functional method in comparison with the results of treatment by orthosis or femoral osteotomy. This method shortened considerably the time of treatment; the average time was 13 months.
对296例佩特兹病患者的334个患髋（38例为双侧受累）采用“扫帚柄石膏”外展内旋位包容原则进行治疗，保持髋关节活动，并持续牵引。记录了预后指标，包括发病年龄、卡特拉尔分组和危险因素。平均随访时间为8.6年。最后一次检查时的平均年龄为14.1岁（范围为6至25岁）。采用海曼和赫恩登商数法通过X线片评估治疗的最终结果。在这334个接受治疗的髋关节中，216例结果非常好，92例结果良好（非常好和良好合计占92%），而23例结果一般，3例结果差（一般和差合计占8%）。结果取决于诊断时的年龄、股骨头受累程度以及“有风险的股骨头”的存在情况，特别是股骨半脱位。结果一般和差的情况见于9岁以上、股骨头完全受累、骨骺粉碎且存在危险因素的儿童。本研究结果表明，与矫形器或股骨截骨术治疗结果相比，佩特兹病功能性治疗方法具有优越性。该方法显著缩短了治疗时间；平均治疗时间为13个月。
