Comparison of femoral and innominate osteotomies for the treatment of Legg-Calvé-Perthes disease.

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.