Westhoff B, Martiny F, Krauspe R
Orthopädische Klinik, Universitätsklinikum Düsseldorf, Moorenstr. 5, 40225, Düsseldorf, Deutschland.
Orthopade. 2013 Dec;42(12):1008-17. doi: 10.1007/s00132-012-2048-y.
The long-term prognosis of Legg-Calvé-Perthes disease primarily depends on the spherical form of the femoral head and the congruency of the hip joint after healing. Of the many factors influencing the outcome only the range of mobility and containment can be addressed therapeutically. The mobility of the joint is maintained or restored through various conservative measures thus reducing joint deforming forces. If loss of containment becomes evident operative treatment is indicated, preferably in the early fragmentation stage. For biomechanical reasons correction of the acetabulum is preferred. For children less than 8.5 years old greater trochanteric apophyseodesis is warranted to prevent trochanteric overgrowth. The results of containment ameliorating surgery are promising. In older children with severe Legg-Calvé-Perthes disease the results are less promising.
Legg-Calvé-Perthes病的长期预后主要取决于股骨头的球形形态以及愈合后髋关节的匹配情况。在众多影响预后的因素中，只有活动范围和包容情况可通过治疗手段加以解决。通过各种保守措施维持或恢复关节的活动度，从而降低关节变形力。如果明显出现包容丧失，则需进行手术治疗，最好在早期碎裂阶段进行。出于生物力学原因，髋臼矫正更为可取。对于8.5岁以下的儿童，有必要进行大转子骨骺固定术以防止大转子过度生长。包容改善手术的效果很有前景。对于患有严重Legg-Calvé-Perthes病的大龄儿童，效果则不太乐观。
