Toma Hugo Futoshi, de Almeida Oliveira Felippe Viana Thiago, Meireles Rostanda Mart, Borelli Isabel Moreira, Blumetti Francesco Camara, Takimoto Eduardo Shoiti, Dobashi Eiffel Tsuyoshi
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Department of Orthopedics and Traumatology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Rev Bras Ortop. 2014 Sep 16;49(5):488-93. doi: 10.1016/j.rboe.2014.09.003. eCollection 2014 Sep-Oct.
To determine whether the clinical variables and preoperative classification of patients with Legg-Calvé-Perthes disease (LCPD) who undergo Salter osteotomy correlate with the radiographic result at the time of skeletal maturity.
In this retrospective cohort study, 47 individuals with LCPD who were treated using Salter osteotomy (1984-2004) were evaluated. The patients were evaluated according to sex, skin color, side affected and age at which osteotomy was performed. The preoperative radiographs were analyzed in accordance with the classifications of Waldenström, Catterall, Laredo and Herring. The radiographs obtained at the time of skeletal maturity were classified using the Stulberg method.
The mean age at the time of surgical treatment was 82.87 months (6.9 years). The age presented a statistically significant correlation with the Stulberg grades at skeletal maturity (p < 0.001). Patients over the age of 6.12 years tended to present less favorable results. The variables of sex, skin color and side affected did not present any statistically significant correlation with the prognosis (p = 0.425; p = 0.467; p = 0.551, respectively). Only the Laredo classification presented a statistically significant correlation with the final result given by the Stulberg classification (p = 0.001). The other classifications used (Waldenström, Catterall and Herring) did not present any correlation between the time at which surgery was indicated and the postoperative result.
The age at which the patients underwent surgical treatment and the Laredo classification groups were the only variables that presented significant correlations with the Stulberg classification.
确定接受Salter截骨术的Legg-Calvé-Perthes病(LCPD)患者的临床变量和术前分类是否与骨骼成熟时的影像学结果相关。
在这项回顾性队列研究中,对47例采用Salter截骨术治疗的LCPD患者(1984 - 2004年)进行了评估。根据患者的性别、肤色、患侧和截骨时的年龄进行评估。术前X线片根据Waldenström、Catterall、Laredo和Herring分类进行分析。骨骼成熟时获得的X线片采用Stulberg方法进行分类。
手术治疗时的平均年龄为82.87个月(6.9岁)。该年龄与骨骼成熟时的Stulberg分级存在统计学显著相关性(p < 0.001)。6.12岁以上的患者往往预后较差。性别、肤色和患侧变量与预后均无统计学显著相关性(p分别为0.425、0.467、0.551)。只有Laredo分类与Stulberg分类给出的最终结果存在统计学显著相关性(p = 0.001)。所使用的其他分类(Waldenström、Catterall和Herring)在手术指征时间与术后结果之间均无相关性。
患者接受手术治疗的年龄和Laredo分类组是仅有的与Stulberg分类存在显著相关性的变量。