Intertrochanteric varus osteotomy in the treatment of Perthes' disease.

Seventy-eight hips with Perthes' disease (LCPD) were treated with an intertrochanteric varus osteotomy. The hips were preoperatively graded according to Catterall's classification. There were 7 Group II, 32 Group III, and 39 Group IV hips. Good results occurred in 5 of the Group II hips, 19 of the Group III hips, and 12 of the Group IV hips. The average age of the patients at the onset of symptoms was 6 years and 6 months, and the average age at the time of the osteotomy was 7 years and 8 months. This means that the average age of patients was high and that the operations were performed in a late state of the disease. A control group consisting of 52 hips was treated conservatively with a Thomas splint. In 11 hips classified as Catterall's Group IV, there were 8 poor results. The results indicate that with osteotomy the results improve in Group IV of Catterall's classification. There are, however, still about 30% poor results in the Group IV. A prolonged prevention of weight-bearing after osteotomy may be indicated in patients with unfavorable results.