Femoral Head Reduction Osteotomy for Deformed Perthes Head Using Ganz Safe Surgical Dislocation of Hip - A Case Report with 3-Year Follow-up.

Abstract

Introduction:Perthes disease often results in a non-spherical deformed femoral head which causes pain, dysfunction, early degeneration, and arthritis in young adults. The importance of preservation of native hip in young adults has been well proven. We report a case of deformed Perthes head treated with femoral head reduction osteotomy using Ganz safe surgical dislocation which is a technically demanding but highly rewarding surgical procedure.Case Report:A 18-year-old female suffering with hip pain and limp for the past 2 years was diagnosed as sequelae of Perthes disease with femoral head deformity. Pre-operative Harris hip score was 54. The patient was planned for joint preservation surgery considering the young age. Ganz safe surgical dislocation was used to expose the hip joint and femoral head reduction osteotomy was done to recreate the sphericity of the femoral head. After 3-year follow-up, the patient had significant pain relief and restoration of function with no evidence of avascular of the femoral head. Post-operative Harris hip score was 82. The treatment of deformed Perthes femoral head remains controversial with no gold standard treatment. Femoral head reduction osteotomy allows the surgeon to reduce the size of the femoral head and restore sphericity of the femoral head preserving the blood supply and helps to improve the functional outcome of the patient. Our case report with 3-year follow-up is evidence to prove the same.Conclusion:Femoral head reduction osteotomy using Ganz safe surgical dislocation is a safe and effective joint preservation surgery to treat deformed Perthes femoral head in adolescent and young adults.