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Journal of Bone and Joint Surgery - British Volume, Vol 86-B, Issue 2, 244-250.
doi: 10.1302/0301-620X.86B2.14284  
Copyright © 2004 by British Editorial Society of Bone and Joint Surgery
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Arthrodiastasis in Perthes’ disease

PRELIMINARY RESULTS

S. L. Maxwell, BSc, Physiotherapist1; K. J. Lappin, FRCS, Orthopaedic Registrar2; W. D. Kealey, MD, Consultant Orthopaedic Surgeon2; B. C. McDowell, PhD, Research Physiotherapist1; and A. P. Cosgrove, MD, FRCS, Consultant Paediatric Orthopaedic Surgeon2

1 Musculoskeletal Education and Research Unit
2 Department of Orthopaedics, Musgrave Park Hospital, Stockman’s Lane, Belfast, BT9 7JB, UK.

Correspondence should be sent to Mr A. P. Cosgrove.

We have examined the effect of arthrodiastasis on the preservation of the femoral head in older children with Perthes’ disease. We carried out a prospective trial in boys over the age of eight years and girls over seven years at the time of the onset of symptoms. The patients had minimal epiphyseal collapse and were compared with a conventionally treated, consecutive, historical control group. Arthrodiastasis was applied for approximately four months. The primary outcome measure was the extent of epiphyseal collapse at the end of the fragmentation phase. One of the 15 treated hips and nine of the 30 control hips showed a loss of height of 50% or more of the lateral epiphyseal column on the anteroposterior radiographs (Herring grade-C classification). On a Lauenstein view, one of the treated hips and 19 of the control hips showed at least a loss of height of 50% of the anterior epiphyseal column. The complications of arthrodiastasis included pin-site infection in most hips, transient joint stiffness in two, and breakage of a pin in two. The final outcome will be known when all the patients and the control group reach skeletal maturity.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General