Heikkinen E, Puranen J
Clin Orthop Relat Res. 1980 Jul-Aug(150):60-8.
The optimal time and type of the varus-innerrotation femoral osteotomy in the treatment of Legg-Calvé-Perthes disease (LCPD) was evaluated on the basis of 53 hips having early operations and 14 hips having late operations and also on the basis of the previous observations on the disturbed venous drainage in various stages of LCPD. The operation should be done as early as possible in the cases in which it is indicated. Both the operative results in the present series and the theoretical background based on the severe disturbances of venous circulation in the initial phases justify an early intervention. The anatomic results of the early operated-on hips (74% good, 17% fair, and 9% poor) were related to the degree of the varusation and to the postoperative uncovering of the head. In the good results, the attained varusation was greater and the positioning of the head within the acetabulum deeper than in the fair or poor results. Accordingly, in "risk" cases, the optimal angle of the neck immediately after the varusation should be 100--100 degrees. With such varusation, it is possible to obtain good containment and a remarkable relief of the load against the femoral head during walking and running.
基于53例早期手术的髋关节和14例晚期手术的髋关节，并依据先前对Legg-Calvé-Perthes病（LCPD）各阶段静脉引流紊乱的观察结果，对治疗Legg-Calvé-Perthes病（LCPD）时内翻内旋股骨截骨术的最佳时间和类型进行了评估。在有手术指征的病例中，手术应尽早进行。本系列的手术结果以及基于疾病初始阶段严重静脉循环紊乱的理论背景均支持早期干预。早期手术髋关节的解剖学结果（74%为优，17%为良，9%为差）与内翻程度及术后股骨头的显露情况有关。在优的结果中，所达到的内翻程度更大，股骨头在髋臼内的位置比良或差的结果更深。因此，在“风险”病例中，内翻后立即获得的最佳颈干角应为100°-100°。通过这样的内翻，可以在行走和跑步过程中获得良好的包容，并显著减轻股骨头所承受的负荷。
