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  • Title: [Roentgenologic investigations on surgical treatment of Perthes' disease. Second communication: results following intertrochanteric varisational osteotomy (author's transl)].
    Author: Reichelt A, Havla D.
    Journal: Z Orthop Ihre Grenzgeb; 1978; 116(2):167-76. PubMed ID: 654455.
    Abstract:
    Follow-up examinations of 37 out of a total of 56 intertrochanteric varisational and partly derotational osteotomies after an average period of 62 months showed more favorable results in all respects. The in-patient treatment period was on the average 15 weeks when using Schanz' screws. In fixation with AO angular plates, the average hospitalization period was 8 weeks (including the second stay in the hospital for the removal of the metal). The regeneration period of the necrotic femoral head was 18 months, and was, therefore, 7 months shorter than after the spiking or nailing operation. Most of the operations took place in the beginning rehabilitation phase (stage 3a), resulting in a below-average regeneration period. Physiological congruence was achieved in 24% of the cases, and deformations of the femoral head were seen in only 19% of the patients. In 62% of the cases, good central positioning of the femoral head was achieved, whereas in 68% the entrance of the acetabulum was wider than on the contralateral, healthy side. The improved head/acetabulum ratio was also documented in a postoperative increase of the angle of the capitular epiphysis to almost 24 degrees. The objective total assessment yielded 68% very good and good results, whereas 19% of the results were considered poor. Basing on the favorable roentgenological and also clinical results which are mainly confirmed by literature references, this method can be considered as the method of choice according to the present state of knowledge.
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