Journal of pediatric orthopedics
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There are concerns of potential growth disturbance after transphyseal reconstruction of the anterior cruciate ligament in skeletally immature patients. The authors used magnetic resonance (MR) imaging to evaluate growth disturbance and associated physeal abnormalities after index surgery. ⋯ Retrospective Case Series, Therapeutic Level IV.
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The goal of intervention in Legg-Calvé-Perthes disease has been to prevent femoral head deformation by containing the head within the acetabulum, using it as a mold for guiding femoral head development. With appropriate proximal femoral morphology, premature arthritis can hopefully be avoided. Both nonsurgical and surgical methods of treatment have evolved over time, from abduction casts and braces to advanced surgical containment methods, which are now the mainstay of treatment. The purpose of this study is to briefly review the evolution of surgical treatment of Legg-Calvé-Perthes disease, and to concentrate on 2 advanced surgical containment methods: combined Salter innominate osteotomy with femoral varus osteotomy and triple pelvic osteotomy.
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Review Historical Article
A brief history of Legg-Calvé-Perthes disease.
Legg-Calvé-Perthes (LCP) disease has an extensive history that has provided an ongoing intellectual challenge for the orthopaedic community. Debate around etiology and treatment of LCP disease continues even after its initial description in the early 1900 s. In order for modern day clinicians to have a full understanding of the condition, one must be a scholar of its development. The purpose of our review will be to discuss the scientific communities' understanding of presentation, etiology, and treatment of LCP disease over time.
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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.