Outcome of arthrodiastasis in treatment of Perthes’ disease

Abstract

Background Hip distraction in Legg–Calve–Perthes disease unloads the joint, which negates the harmful effect of the stresses on the articular surface, which may promote the sound healing of the areas of necrosis. Patients and methods Nonarticulated arthrodiastasis without soft tissue release using an Ilizarov external fixator was applied to 45 patients (50 hips) with Legg–Calve–Perthes disease (>8 years at onset and lateral pillar type C or B). Results Follow-up period ranged from 1 to 8 years, with an average of 3 years. Forty-five (90%) hips had improvement of the range of motion postoperatively. Preoperatively, all patients had constant pain, whereas at last follow-up 40 (80%) patients had no pain and had an improvement. Stulberg classification was applied to 20 cases who reached skeletal maturity at the last follow-up: eight cases were type II, five cases were type III, five cases were type IV, and two cases were type V. Conclusion Nonarticulated hip distraction without soft tissue release seems to be a valid treatment option in cases with Legg–Calve–Perthes disease where poor results are expected from conventional treatment.