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The etiology of Perthes' disease
ABSTRACTS
typical auger injuries, but illustrate the carelessness which causes many of these disastrous injuries, Improved safety education for the entire farm family as well as improved design of safety shields on all types of auger equipment are urged. Colin C. Ferguson Posterior lilac Osteotomy for Fixed Pelvic Obliquity. R. E. Lindseth. J Bone Joint Surg 60A: 17-22 (January), 1978.
Nine patients, with myelomeningocele paralytic fixed pelvic obliquity, were treated by a bilateral posterior iliac osteotomy procedure. The procedure involves an opening wedge osteotomy on one side of the pelvis and bone graft with bone taken from the opposite osteotomized peIvis. The procedure produced a mean correction of 14~ of pelvic obliquity (41%), and an improvement of spinal compensation based upon a mid-line plumb of 7 cm (69%). The results of 2 7-yr follow-up were permanent in their degree of correction. All patients were subjectively improved in that they were better sitters with absence of ischial decubiti and/or hip dislocation. One patient went on to progressive scolios~s which required treatment, Complications were felt to beon the basis of technical errors with one procedure inadvertently being performed through the sacro-iliac joint. The second patient had a fracture of the ilium through a bone graft donor site with some loss of correction. One patient had a wound infection resolving with conservative care and a final patient had a partial sciatic nerve palsy with full recovery at 3 me. Anthony H. Alter Complications of Cuneiform Osteotomy for Moderately Severely Slipped Capital Femoral Epiphysis. J. R. Gage,
A. B. Sundberg, D R. No~an, R. G. Sletten. and R. B. Winter. J Bone JointSurg60A:157 165: (March), 1978. Seventy-one transcervical cuneiform wedge osteotomies were performed for malunions of slipped capital femoral epiphyses. The procedure included a t-shaped incision of the femoral hip joint capsule. Twenty-nineof these hips went on to cartilage necrosis which included 13 of the above 29 having osteonecrosis. Twenty-one hips with only cartilage necrosis showed partial to complete recovery of cartilage space over the course of 19 me. There was no correlation between the onset of osteonecrosis with the severity of preoperative epiphyseal displacement; amount of correction achieved by the osteotomy; or type of postoperative immobilization. There was tentative data that postoperative traction may have diminished the incidence of osteonecrosis. There were six additional patients where the osteotomy was performed at the junction of the femoral neck with the troehanter and the results in these patients were without cartilage necrosis or osteonecrosis. The authors are discontinuing the transcervical procedure and hope that the more lateral basilar neck procedure will afford the results desired. Anthony H. Alter Pemberton's Acetabu!oplasty for Congenital Dislocation or Subluxation of the Hip. A. L. Eyre-Brook, D. Anlhony Jones, and F. C. Harris. J Bone Joint Surg60B:18-24(Febraary), 1978. The results of a consecutive ,series of 37 acetabuloplasty operations of the Pemberton type are described. Although closed reduction following a period of Skin traction was used in some, the authors favor routine open reduction to obtain
551
full concentric reduction. Rotation osteotomy was added if anteversion of more than 30~ was present. DetalJeddescription of operative m e t h o d s of open reduction and Pemberton's acetabuloplasty are given. When open reduction and acetabuloplasty were performed as primary treatment the results were e'xcellent in all. Less za:tisfactery results were obtained in patients with acet.abuloplasty alone~ or performed as secondary treatment. M.G. 1-1.Smith The Etiology of Perthes" Disease. R. Wy.nne-D,avies and J. Gormley. J Bone Joint Surg, 60B:6-14 (February), 1978.
In a review of 310 patients with Perthes" disease, a study has been made of genetic, epidemiologic, and gr.owth factors. No pattern of inheritance was found but an increased incidence was found among the third born or later children in the family and among low-income families. Many children were undersized at the time of developing Perthes' disease. but small size was not noted in their parents. M.G.H. Smith Legg-Perthes" Disease in Children Less than Four Years Old.
T. E. Clarke. T. L. Finnegan. R. L. Fisher. IV. H. ,Bunch. and H. R. Gossling. J Bone Joint Surg 60A:166-168 (March), 1968. Eighty-two youngsters, less than 4 yr of age, with LeggPerthes' disease, were studied. Twenty-six had minimal to no treatment, including at the most a bent-krtee brace of Snyder sling. Fifty-six hips in 47 children were treated with the Newington Childrens" Hospital technique of recumbency with the addition of abduction bradng and physical therapy until healing could be proved. Results with unilateral and bilateral disease were the same. The results of the treated and untreated groups were the same in hips with minimal inolvement. The data document that kigb risk hips (Catterall Group III and IV) did better with the treatment program of bedrest and containmem bracing tmtil sign-free plus showing healingon x-ray--Anthonjr 11. Alter Perthes' Disease of a Severe Type Developing After Satisfactory Closed Reduction of Congenital Dislocation of the Hip. 7". S. Lindholm. L.-E. Lau.rent. K. Ogterman. and
O. Snellman. J Bone ICmt Surg 60B:15-t7 (Febr~aary), 1978. In what is the first report of the occurrence o f this r tion, three children are described i~ w ~ m cong:emt~l dislocation of the hip treated sucoessfulJ.y by the ag~of2 yr, a M in whom the femor~ heads were ~torc~al f~r some year~., developed Perthes" disease at the aggs ,of 6, 7, and 9 yr. A special feature of the condition was aeetabular dysplasia of severe degree which did not respond to femoral varas osteotomy. M. G. H. Smith The Effect of Hip Reduction on Fulaction in Patients With Meningocele: Potential Gains arid Hazards ~.Witb '$,~rgh~l
Treatment. E. Feiwell, Sakai, and T. BLalr J Bone Jo~t Surg60A:169-173 (March), 1978. Seventy-six myelomeningocele pati,en,ts wkt~a hi~ deformities, over 5 yr of age, including 4! ~o~op,r~tive cases plus 35 operative cases, were studied. The stu,die~ show thai the effects of treatment of the hips had no r on the patient's ultimate ability to ambulate, wear braces and sit. As documented by the other study~ based at Ra~dm Lo~
typical auger injuries, but illustrate the carelessness which causes many of these disastrous injuries, Improved safety education for the entire farm family as well as improved design of safety shields on all types of auger equipment are urged. Colin C. Ferguson Posterior lilac Osteotomy for Fixed Pelvic Obliquity. R. E. Lindseth. J Bone Joint Surg 60A: 17-22 (January), 1978.
Nine patients, with myelomeningocele paralytic fixed pelvic obliquity, were treated by a bilateral posterior iliac osteotomy procedure. The procedure involves an opening wedge osteotomy on one side of the pelvis and bone graft with bone taken from the opposite osteotomized peIvis. The procedure produced a mean correction of 14~ of pelvic obliquity (41%), and an improvement of spinal compensation based upon a mid-line plumb of 7 cm (69%). The results of 2 7-yr follow-up were permanent in their degree of correction. All patients were subjectively improved in that they were better sitters with absence of ischial decubiti and/or hip dislocation. One patient went on to progressive scolios~s which required treatment, Complications were felt to beon the basis of technical errors with one procedure inadvertently being performed through the sacro-iliac joint. The second patient had a fracture of the ilium through a bone graft donor site with some loss of correction. One patient had a wound infection resolving with conservative care and a final patient had a partial sciatic nerve palsy with full recovery at 3 me. Anthony H. Alter Complications of Cuneiform Osteotomy for Moderately Severely Slipped Capital Femoral Epiphysis. J. R. Gage,
A. B. Sundberg, D R. No~an, R. G. Sletten. and R. B. Winter. J Bone JointSurg60A:157 165: (March), 1978. Seventy-one transcervical cuneiform wedge osteotomies were performed for malunions of slipped capital femoral epiphyses. The procedure included a t-shaped incision of the femoral hip joint capsule. Twenty-nineof these hips went on to cartilage necrosis which included 13 of the above 29 having osteonecrosis. Twenty-one hips with only cartilage necrosis showed partial to complete recovery of cartilage space over the course of 19 me. There was no correlation between the onset of osteonecrosis with the severity of preoperative epiphyseal displacement; amount of correction achieved by the osteotomy; or type of postoperative immobilization. There was tentative data that postoperative traction may have diminished the incidence of osteonecrosis. There were six additional patients where the osteotomy was performed at the junction of the femoral neck with the troehanter and the results in these patients were without cartilage necrosis or osteonecrosis. The authors are discontinuing the transcervical procedure and hope that the more lateral basilar neck procedure will afford the results desired. Anthony H. Alter Pemberton's Acetabu!oplasty for Congenital Dislocation or Subluxation of the Hip. A. L. Eyre-Brook, D. Anlhony Jones, and F. C. Harris. J Bone Joint Surg60B:18-24(Febraary), 1978. The results of a consecutive ,series of 37 acetabuloplasty operations of the Pemberton type are described. Although closed reduction following a period of Skin traction was used in some, the authors favor routine open reduction to obtain
551
full concentric reduction. Rotation osteotomy was added if anteversion of more than 30~ was present. DetalJeddescription of operative m e t h o d s of open reduction and Pemberton's acetabuloplasty are given. When open reduction and acetabuloplasty were performed as primary treatment the results were e'xcellent in all. Less za:tisfactery results were obtained in patients with acet.abuloplasty alone~ or performed as secondary treatment. M.G. 1-1.Smith The Etiology of Perthes" Disease. R. Wy.nne-D,avies and J. Gormley. J Bone Joint Surg, 60B:6-14 (February), 1978.
In a review of 310 patients with Perthes" disease, a study has been made of genetic, epidemiologic, and gr.owth factors. No pattern of inheritance was found but an increased incidence was found among the third born or later children in the family and among low-income families. Many children were undersized at the time of developing Perthes' disease. but small size was not noted in their parents. M.G.H. Smith Legg-Perthes" Disease in Children Less than Four Years Old.
T. E. Clarke. T. L. Finnegan. R. L. Fisher. IV. H. ,Bunch. and H. R. Gossling. J Bone Joint Surg 60A:166-168 (March), 1968. Eighty-two youngsters, less than 4 yr of age, with LeggPerthes' disease, were studied. Twenty-six had minimal to no treatment, including at the most a bent-krtee brace of Snyder sling. Fifty-six hips in 47 children were treated with the Newington Childrens" Hospital technique of recumbency with the addition of abduction bradng and physical therapy until healing could be proved. Results with unilateral and bilateral disease were the same. The results of the treated and untreated groups were the same in hips with minimal inolvement. The data document that kigb risk hips (Catterall Group III and IV) did better with the treatment program of bedrest and containmem bracing tmtil sign-free plus showing healingon x-ray--Anthonjr 11. Alter Perthes' Disease of a Severe Type Developing After Satisfactory Closed Reduction of Congenital Dislocation of the Hip. 7". S. Lindholm. L.-E. Lau.rent. K. Ogterman. and
O. Snellman. J Bone ICmt Surg 60B:15-t7 (Febr~aary), 1978. In what is the first report of the occurrence o f this r tion, three children are described i~ w ~ m cong:emt~l dislocation of the hip treated sucoessfulJ.y by the ag~of2 yr, a M in whom the femor~ heads were ~torc~al f~r some year~., developed Perthes" disease at the aggs ,of 6, 7, and 9 yr. A special feature of the condition was aeetabular dysplasia of severe degree which did not respond to femoral varas osteotomy. M. G. H. Smith The Effect of Hip Reduction on Fulaction in Patients With Meningocele: Potential Gains arid Hazards ~.Witb '$,~rgh~l
Treatment. E. Feiwell, Sakai, and T. BLalr J Bone Jo~t Surg60A:169-173 (March), 1978. Seventy-six myelomeningocele pati,en,ts wkt~a hi~ deformities, over 5 yr of age, including 4! ~o~op,r~tive cases plus 35 operative cases, were studied. The stu,die~ show thai the effects of treatment of the hips had no r on the patient's ultimate ability to ambulate, wear braces and sit. As documented by the other study~ based at Ra~dm Lo~