Abstract
Background: Legg-Calve-Perthes (LCP) disease, or idiopathic avascular necrosis of the femoral head occurs during early childhood and is caused by impaired circulation in the femoral head. Varus derotation osteotomy (VDO) was described over half a century ago, and is now a popular method for the operative treatment of Perthes disease.
 Objective: To find out the clinical and radiological outcome of varus derotation osteotomy for containment of femoral head in advanced Perthes disease.
 Materials and Methods: This observational study was conducted in the Department of Orthopaedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbag, Dhaka from March 2015 to September 2017. Total 20 cases of advanced Perthes disease were enrolled. Pre- and post-operative period were evaluated by interview and clinical examination by using a semi-structured questionnaire. Demographic and clinical information were recorded. All patients had a pre- and post-operative x-rays. We used visual analog scales (VAS) for scoring pain; Wiberg’s central edge angle, epiphyseal extraction index, neck shaft angle and Larson (Iowa) hip score were used to assess the outcome of VDO. Comparison of continuous variables between the two groups was made with Student’s t-tests. Comparison of proportions between Herring groups B and C were made with chi-square tests. p<0.05 was considered as significant. All the data were compiled and sorted properly and the quantitative data were analyzed statistically by using Statistical Package for Social Sciences (SPSS 22.0).
 Results: In the present study, mean visual analog scale (VAS) score and epiphyseal extraction index (EEI) were significantly (p<0.001) lower in Herring Group B in comparison to that of Group C, but mean WCEA, NSA and HLS were significantly (p<0.001) higher in Herring Group B in comparison to that of Group C.
 Conclusion: Varus osteotomy gives good results in children aged 6–12 years who do not exhibit any femoral head deformity or flattening, especially those with good containment in abduction in advance Perthes disease.
 J Enam Med Col 2020; 10(2): 79-85
Highlights
Legg-Calve-Perthes disease (LCPD) is an aseptic, noninflammatory, self-limited condition of the immature hip characterized by idiopathic osteonecrosis of the femoral epiphysis, followed by a subchondral fracture, fragmentation, revascularization and remodeling
Outcome of varus derotation osteotomy for containment of femoral head was measured by using Visual Analogue Scale (VAS), Wiberg’s central edge angle, epiphyseal extraction index, neck shaft angle and Larson (Iowa) hip score
In this study among 20 cases, 10 subjects were of Herring classification of Perthes disease Group B and 10 subjects were of Group C
Summary
Legg-Calve-Perthes disease (LCPD) is an aseptic, noninflammatory, self-limited condition of the immature hip characterized by idiopathic osteonecrosis of the femoral epiphysis, followed by a subchondral fracture, fragmentation, revascularization and remodeling. It is associated with both substantial hip pain and dysfunction during the disease process as well as later in adulthood. Objective: To find out the clinical and radiological outcome of varus derotation osteotomy for containment of femoral head in advanced Perthes disease. Conclusion: Varus osteotomy gives good results in children aged 6–12 years who do not exhibit any femoral head deformity or flattening, especially those with good containment in abduction in advance Perthes disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
