Ismail A M, Macnicol M F
Princess Margaret Rose Orthopaedic Hospital, Edinburgh, Scotland, UK.
J Bone Joint Surg Br. 1998 Mar;80(2):310-4. doi: 10.1302/0301-620x.80b2.8054.
We compared the prognostic value of the Catterall grouping, the Salter-Thompson grading, the arthrographic shape of the femoral head, and the Herring lateral pillar grouping during the fragmentation stage of Perthes' disease in 73 patients with 81 affected hips. Radiographs were available for study from the onset of the disease until skeletal maturity. We used the Stulberg classification to assess outcome. The Herring grade and arthrographic sphericity proved to be the best predictors of final outcome. Combining these two values further increased the predictive value. All but one patient in Herring group A achieved an excellent outcome. In Herring group B, the age of the child and the sphericity of the femoral head influenced the end result. If the child was less than seven years old at the onset of symptoms the prognosis was invariably good and all spherical hips in group B had a good outcome with Stulberg grades 1 or 2. Moderately and severely deformed hips on arthrography resulted in Stulberg 3 and 4 hips. None of the hips in Herring group C had a normal appearance at maturity and the outcome was not significantly influenced by the age at onset or the arthrographic appearance.
我们比较了卡特拉尔（Catterall）分型、索尔特 - 汤普森（Salter - Thompson）分级、股骨头造影形态以及赫林（Herring）外侧柱分型在73例患有81个患髋的佩特兹（Perthes）病碎裂期的预后价值。从疾病发作至骨骼成熟阶段均有X线片可供研究。我们采用斯图尔伯格（Stulberg）分类法评估预后。结果证明，赫林分级和造影球形度是最终预后的最佳预测指标。将这两个指标结合起来可进一步提高预测价值。赫林A组除1例患者外均获得了优异的预后。在赫林B组，患儿年龄和股骨头球形度影响最终结果。如果患儿症状发作时年龄小于7岁，预后总是良好，且B组所有球形髋关节的斯图尔伯格分级为1级或2级，预后良好。造影显示中度和重度变形的髋关节最终斯图尔伯格分级为3级和4级。赫林C组没有一个髋关节在成熟时外观正常，其预后不受发病年龄或造影表现的显著影响。
