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DIFFERENT METHODS OF TREATMENT RELATED TO THE BILATERAL OCCURRENCE OF PERTHES’ DISEASE

Department of Orthopaedic Surgery, Kobe City General Hospital, Kobe, Hyogo 650, Japan.

S. Suzuki, MD, PhD, Director

Department of Orthopaedic Surgery, Shiga Medical Centre for Children, 120-6 Moriyama-chyo, Shiga 524, Japan.

Correspondence should be sent to Dr T. Futami at the Department of Orthopaedic Surgery, Kyoto National Hospital, 1-1 Mukohata-chyo, Fuka-kusa, Fushimi-ku, Kyoto 612, Japan.

We treated 98 consecutive patients with Perthes’ disease by a unilateral brace in external rotation, flexion and abduction and a further consecutive 110 by a bilateral cast with the hips in internal rotation and abduction.

During treatment in the unilateral brace, six (6.1%) hips on the opposite side developed evidence of Perthes’ disease and one developed this after the brace had been removed. In children managed in bilateral casts, no contralateral Perthes’ disease was seen. Adequate containment of the femoral head may prevent subsequent changes in the opposite hip.