Department of Orthopaedics and Traumatology, Giresun University, School of Medicine, 28100 Giresun, Turkey.
Arch Orthop Trauma Surg. 2012 Jan;132(1):87-92. doi: 10.1007/s00402-011-1382-6. Epub 2011 Aug 28.
The purpose of this study was to compare the results of conservative and surgical treatment in a homogeneous group constituted by patients between 6 and 8 years of age at onset of the Perthes disease with Herring B involvement.
Twenty-seven hips of 25 patients were evaluated radiologically and clinically. Patients were divided into two groups in terms of treatment type. In group I [16 hips of 14 patients], hips were treated conservatively using Thomas splints. The mean follow-up period was 21.5 (10-25) years. In group II [11 patients], hips were treated surgically using femoral osteotomy. The mean follow-up period was 14.3 (8-20) years.
There was no statistically significant difference between the groups in terms of Stulberg classification, but surgically treated patients had more varus angle, more shortening, and more trochanteric overgrowth compared with the braced group.
Non-surgical treatment with a brace is a reliable alternative to surgical treatment in Perthes disease between 6 and 8 years of age at onset with Herring B involvement. However, we could not know whether the good results were influenced by the brace or stemmed from having good prognosis of these patients.
本研究旨在比较发病年龄在 6 至 8 岁之间且 Herring B 型受累的儿童保髋治疗与手术治疗的结果。
对 25 例患者的 27 髋进行影像学和临床评估。根据治疗类型将患者分为两组。在组 I（14 例患者的 16 髋）中，使用托马斯支架进行保守治疗。平均随访时间为 21.5（10-25）年。在组 II（11 例患者）中，使用股骨截骨术进行手术治疗。平均随访时间为 14.3（8-20）年。
两组的 Stulberg 分类无统计学差异，但与支具组相比，手术组的内翻角更大，短缩更多，大转子过度生长更多。
对于发病年龄在 6 至 8 岁之间且 Herring B 型受累的儿童，使用支具进行非手术治疗是手术治疗的可靠替代方法。然而，我们无法确定良好的结果是由支具还是这些患者的良好预后引起的。
