Citlak Atilla
Orthopaedics and Traumatology Department, School of Medicine, Karadeniz Technical University, Trabzon, Turkey.
Medicine (Baltimore). 2020 Feb;99(7):e19041. doi: 10.1097/MD.0000000000019041.
In this retrospective observational study, I aimed to report long-term follow-up results of femoral varus osteotomy in the treatment of Perthes disease patients who were between 6 and 8 years old at the onset of the disease with Herring B and C hip involvement. I also aimed to compare 2 different osteotomy techniques: open-wedge and closed-wedge femoral varus osteotomies.Patients with Perthes disease treated with femoral varus osteotomies were invited for final examination. Twenty two hips of 19 patients were evaluated. Mean follow-up period was 15.2 years. Patients were divided into 2 homogenous groups according to femoral osteotomy technique. In Group A (12 hips) open-wedge osteotomy, and in Group B (10 hips) closed-wedge osteotomy was performed.There were 15 male (78.9%) and 4 female (21.1%) patients. The median age at the onset of the disease was 7 years in Group A and B. The mean follow-up period was 16.2 years in Group A, and 11.4 years in Group B. According to Stulberg classification 5 hips (22.7%) were healed as Class I, 4 hips (18.2%) were healed as Class II, 12 hips (55.5%) were healed as Class III, and 1 hip (4.6%) was healed as Class IV. Also in Group A 4 hips (33.3%) were healed as Class I or II, 7 hips (58.3%) were healed as Class III, and 1 hip (8.3%) was healed as Class IV; in Group B 5 hips (50.0%) were healed as Class I or II, and 5 hips were healed as Class III (50.0%). There was no significant difference between the groups. According to Iowa scale, mean values were 92.6 in Group A and 92.4 in Group B. There was no significant difference between the groups. At the final follow-up mean center-edge angles of Group A and B were 16 and 22, the difference was significant.Long-term follow-up results showed that femoral varus osteotomy was an effective treatment method in Perthes disease patients who were between 6 and 8 years old with Herring B and C hip involvement at the onset of the disease. Hip joint congruency was obtained with femoral varus osteotomies, and closed-wedge osteotomy served more favorable center-edge angle results.
在这项回顾性观察研究中，我的目的是报告内翻截骨术治疗发病时年龄在6至8岁、髋关节受累为Herring B型和C型的佩特兹病患者的长期随访结果。我还旨在比较两种不同的截骨技术：开放楔形和闭合楔形股骨内翻截骨术。邀请接受股骨内翻截骨术治疗的佩特兹病患者进行最终检查。对19例患者的22个髋关节进行了评估。平均随访期为15.2年。根据股骨截骨技术将患者分为两个同质组。A组（12个髋关节）采用开放楔形截骨术，B组（10个髋关节）采用闭合楔形截骨术。有15名男性（78.9%）和4名女性（21.1%）患者。A组和B组疾病发病的中位年龄均为7岁。A组的平均随访期为16.2年，B组为11.4年。根据Stulberg分类，5个髋关节（22.7%）愈合为I级，4个髋关节（18.2%）愈合为II级，12个髋关节（55.5%）愈合为III级，1个髋关节（4.6%）愈合为IV级。同样在A组中，4个髋关节（33.3%）愈合为I级或II级，7个髋关节（58.3%）愈合为III级，1个髋关节（8.3%）愈合为IV级；在B组中，5个髋关节（50.0%）愈合为I级或II级，5个髋关节愈合为III级（50.0%）。两组之间无显著差异。根据爱荷华评分，A组的平均值为92.6，B组为92.4。两组之间无显著差异。在最终随访时，A组和B组的平均中心边缘角分别为16和22，差异显著。长期随访结果表明，内翻截骨术是治疗发病时年龄在6至8岁、髋关节受累为Herring B型和C型的佩特兹病患者的有效治疗方法。通过股骨内翻截骨术可获得髋关节的一致性，并且闭合楔形截骨术能获得更有利的中心边缘角结果。
