Journal of pediatric orthopedics
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The year 2010 is the 100th anniversary of the publication of the first 3 reports describing Legg- Calve-Perthes disease (LCPD). This paper summarizes available evidence previously published and discussed at the several world conferences honoring the occasion. ⋯ There is valid evidence of an association between surgical treatment of certain patients with LCPD and improved radiographic outcome.
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In a preliminary report in 1965, Axer proposed femoral varus derotation osteotomy as an alternative method for treating Legg-Calve-Perthes disease. Thereafter, this became one of the most popular operative methods in the treatment of the disease. A literature analysis of this method experienced during the years is discussed and the investigator's personal approach is described.
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The pathology of late-onset Legg-Calve-Perthes disease (LCPD) is similar to that of avascular necrosis of the femoral head in adult and is associated with poorer prognosis of the hip. The optimal treatment for this condition is still controversial. The purpose of this study was to evaluate the long-term clinical results of the transtrochanteric rotational osteotomy for the patients with LCPD onset at more than 9 years of age. ⋯ Transtrochanteric rotational osteotomy is an effective procedure to salvage the hips of the late-onset LCPD. Amount of head involvement, posterior and lateral pillar had influences on the surgical outcomes.
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A pathognomonic finding of slipped capital femoral epiphysis (SCFE) is a combination of the decrease in the height of the slipped epiphysis and the position of external rotation and flexion of hip. We believe that decrease in the acetabulotrochanteric distance (ATD) on an anteroposterior (AP) radiograph represents this finding. ⋯ Level IV.
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Hip replacement arthroplasty is a very reliable and effective therapeutic modality for patients with end-stage degenerative coxarthrosis secondary to Legg-Calvé-Perthes disease (LCPD). Long-term results of the conventional total hip arthroplasty for patients with LCPD have been reported to be satisfactory similar to those for patients with primary arthritis. For selective patients, resurfacing arthroplasty can be performed successfully. We described special aspects of patients with LCPD in conventional total hip arthroplasty and resurfacing arthroplasty.