RESUMEN
Wedge osteotomy of the femoral neck for slipped capital femoral epiphysis was performed in seventy-seven hips of seventy-one children at Gillette Children's Hospital during the period 1938 to 1973. The major complications were avascular necrosis (28.5 per cent) and cartilage necrosis (37.6 per cent). This high incidence of severe complications led to the use of an osteotomy through the base of the neck for the treatment of severely slipped capital femoral epiphysis which has given satisfactory results in six hips to date.
Asunto(s)
Enfermedades de los Cartílagos/etiología , Cartílago Articular , Epífisis Desprendida/cirugía , Necrosis de la Cabeza Femoral/etiología , Cabeza Femoral , Osteotomía/efectos adversos , Adolescente , Tornillos Óseos , Enfermedades de los Cartílagos/diagnóstico por imagen , Cartílago Articular/irrigación sanguínea , Cartílago Articular/diagnóstico por imagen , Niño , Epífisis Desprendida/diagnóstico por imagen , Femenino , Cabeza Femoral/irrigación sanguínea , Cabeza Femoral/diagnóstico por imagen , Necrosis de la Cabeza Femoral/diagnóstico por imagen , Estudios de Seguimiento , Humanos , Masculino , RadiografíaRESUMEN
Forty-six patients with Perthes disease treated nonoperatively were reviewed 10 to 43 years later. The median follow-up was 17 years. The patients were analyzed according to sex, age of onset, quantity of head involvement, type of treatment, duration of treatment, functional end result based on the Harris hip scale, and anatomic end result based on Mose templete evaluation. Most patients were treated with an ischial weight-bearing brace. The anatomic results of this treatment tended to be poor, probably worse than no treatment at all. In general, poor results were correlated with late onset, greater quantity of head involvement, and lateral subluxation of the femoral head. As reported in other series, the anatomic results did not correlate well with the functional results, only two patients having Harris hip scales below 70.