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Two groups of patients with severe forms of Perthes disease were studied. Containment was obtained by performing a derotation varus osteotomy in 32 hips, and by casts and splints in 12 hips. The clinical results were better in the operated group than in the nonoperated group. Seventy-five percent of the hips in the operated group had good to fair radiological results, compared with 41% fair results only in the nonoperated group. The various radiological methods of assessment are outlined. It is concluded that derotation varus osteotomy has advantages over nonoperative treatment in severe Perthes disease, especially in Catterall grade 4 hips.
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