Hip arthrodiastasis in Legg-Calvé-Perthes disease. 2016

I Aguado-Maestro, and J C Abril, and A Bañuelos Diaz, and M García Alonso
Hospital Infantil Universitario Niño Jesús, Madrid, España; Hospital Universitario del Río Hortega, Valladolid, España. Electronic address: i.aguadomaestro@gmail.com.

OBJECTIVE Arthrodiastasis consists of the mobilisation of the hip while distracted by a hinged distractor. The aim of our study is to show the results of the treatment of late-onset Perthes disease with this technique in our institution. METHODS Ambispective review of all the cases that underwent this surgery in our Department of Paediatric Orthopaedics between 2010 and 2014 with the following inclusion criteria: patients over 8 years old, with minimal deformity, and poor prognosis. Mobility, pain, Trendelenburg sign, radiographic sphericity, and complications were assessed. RESULTS A total of 13 patients (9 male, 4 female) were included. The mean age was 11.93 years. Radiographic risk signs were present in 7 cases. The mean decrease in pain measured with a visual analogue scale (VAS) after the surgery was 3.83 points (P<.05). Cephalic sphericity was maintained in 11 cases during follow up (1.75 years). Complications were observed complications in 84.6% of the patients, with infection of the screw tract being the most frequent. All of them were easy to treat. CONCLUSIONS Arthrodiastasis is a minimally invasive technique, useful in the treatment of late onset Perthes disease. It improves clinical results and maintains cephalic shape when applied in early stages. However, it is not free of complications, which can involve as many as 8 out of 10 patients treated with the technique.

UI MeSH Term Description Entries
D007873 Legg-Calve-Perthes Disease A particular type of FEMUR HEAD NECROSIS occurring in children, mainly male, with a course of four years or so. Coxa Plana,Legg-Perthes Disease,Perthes Disease,Legg-Calve-Perthes Syndrome,Legg-Calvé-Perthes Disease,Legg-Calvé-Perthes Syndrome,Osteochondritis Deformans,Disease, Legg-Calve-Perthes,Disease, Legg-Calvé-Perthes,Disease, Legg-Perthes,Disease, Perthes,Legg Calve Perthes Disease,Legg Calve Perthes Syndrome,Legg Calvé Perthes Disease,Legg Calvé Perthes Syndrome,Legg Perthes Disease,Osteochondritis Deforman,Syndrome, Legg-Calve-Perthes,Syndrome, Legg-Calvé-Perthes
D008297 Male Males
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D005260 Female Females
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D016267 External Fixators External devices which hold wires or pins that are placed through one or both cortices of bone in order to hold the position of a fracture in proper alignment. These devices allow easy access to wounds, adjustment during the course of healing, and more functional use of the limbs involved. Fixation Devices, External,Device, External Fixation,Devices, External Fixation,External Fixation Device,External Fixation Devices,External Fixator,Fixation Device, External,Fixator, External,Fixators, External

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