Sponseller P D, Desai S S, Millis M B
Department of Orthopaedic Surgery, Children's Hospital, Boston. Massachusetts 02115.
J Bone Joint Surg Am. 1988 Sep;70(8):1131-9.
The outcomes of forty-two femoral osteotomies and forty-nine innominate osteotomies for the treatment of Catterall grade-III or IV Legg-Calvé-Perthes disease were compared. The average length of follow-up was nine years (range, three to seventeen years). For the patients who were less than ten years old at the onset of the disease, there was no difference in the results of the two procedures, even when the results were analyzed according to age. However, the center-edge angle, neck-shaft angle, lengths of the limbs, range of abduction, and total range of motion were closer to normal after an innominate osteotomy. There was no difference in the ratings when the results of the two operations were compared according to the several parameters that have been proved to be associated with the long-term outcome for hips in patients who have Legg-Calvé-Perthes disease. However, the innominate osteotomy seemed to be the better procedure when involvement of the growth plate was likely to cause coxa vara or a substantial discrepancy in the lengths of the limbs. The patients who were more than ten years old at the onset of the disease had a poor result with either procedure.
比较了42例股骨截骨术和49例髋臼截骨术治疗卡特拉尔III级或IV级Legg-Calvé-Perthes病的疗效。平均随访时间为9年（范围3至17年）。对于发病时年龄小于10岁的患者，即使按年龄分析结果，两种手术的疗效也无差异。然而，髋臼截骨术后，中心边缘角、颈干角、肢体长度、外展范围和总活动范围更接近正常。根据已被证明与Legg-Calvé-Perthes病患者髋关节长期预后相关的几个参数比较两种手术的结果时，评分无差异。然而，当生长板受累可能导致髋内翻或肢体长度明显差异时，髋臼截骨术似乎是更好的手术方法。发病时年龄超过10岁的患者，两种手术的效果均较差。
