{"title":"股骨头前部骨吸收模式对legg - calv<s:1> - perthes病的预后价值。","authors":"Kenichi Mishima, Yasunari Kamiya, Masaki Matsushita, Shiro Imagama","doi":"10.1177/18632521231164985","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To examine whether differences in bone resorption patterns in the anterior portion of the femoral head correlate with the prognosis of Legg-Calvé-Perthes disease.</p><p><strong>Methods: </strong>Seventy-eight patients with unilateral Legg-Calvé-Perthes disease, who were diagnosed after 6.0 years of age, underwent the Salter innominate osteotomy from 1987 to 2013, and were followed up to skeletal maturity. The anterior bone resorption pattern of the femoral head was evaluated from a frog-leg lateral hip radiograph made in the middle of the fragmentation period, and classified into two types, an epiphysis-preserved type (P) and a physis-disrupted type (D). The correlation between the type of bone resorption and the Stulberg outcome was analyzed.</p><p><strong>Results: </strong>The Stulberg outcomes were grade I for 9 patients, grade II for 31, grade III for 35, and grade IV for 3, with a mean follow-up period of 8.3 ± 2.7 years. Fifty-one patients demonstrated the type P hips and 27 did the type D hip. In a subset analysis of patients with the modified lateral pillar group-B hips in the younger group (6.0-8.9 years of age at diagnosis), the percentages of the favorable and unfavorable outcomes significantly differed between the two types (<i>p</i> = 0.013). Anteroposterior enlargement of the affected femoral head was significantly greater in the type D hips than the type P hips (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>Unfavorable hip morphology at skeletal maturity can be predicted in patients with the lateral pillar group-B hips by focusing on bone resorption patterns of the anterior portion of the femoral head.</p><p><strong>Level of evidence: </strong>Level III, prognostic study.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/72/10.1177_18632521231164985.PMC10242379.pdf","citationCount":"0","resultStr":"{\"title\":\"Prognostic value of bone resorption pattern in the anterior portion of the femoral head in Legg-Calvé-Perthes disease.\",\"authors\":\"Kenichi Mishima, Yasunari Kamiya, Masaki Matsushita, Shiro Imagama\",\"doi\":\"10.1177/18632521231164985\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To examine whether differences in bone resorption patterns in the anterior portion of the femoral head correlate with the prognosis of Legg-Calvé-Perthes disease.</p><p><strong>Methods: </strong>Seventy-eight patients with unilateral Legg-Calvé-Perthes disease, who were diagnosed after 6.0 years of age, underwent the Salter innominate osteotomy from 1987 to 2013, and were followed up to skeletal maturity. The anterior bone resorption pattern of the femoral head was evaluated from a frog-leg lateral hip radiograph made in the middle of the fragmentation period, and classified into two types, an epiphysis-preserved type (P) and a physis-disrupted type (D). The correlation between the type of bone resorption and the Stulberg outcome was analyzed.</p><p><strong>Results: </strong>The Stulberg outcomes were grade I for 9 patients, grade II for 31, grade III for 35, and grade IV for 3, with a mean follow-up period of 8.3 ± 2.7 years. Fifty-one patients demonstrated the type P hips and 27 did the type D hip. In a subset analysis of patients with the modified lateral pillar group-B hips in the younger group (6.0-8.9 years of age at diagnosis), the percentages of the favorable and unfavorable outcomes significantly differed between the two types (<i>p</i> = 0.013). Anteroposterior enlargement of the affected femoral head was significantly greater in the type D hips than the type P hips (<i>p</i> = 0.014).</p><p><strong>Conclusion: </strong>Unfavorable hip morphology at skeletal maturity can be predicted in patients with the lateral pillar group-B hips by focusing on bone resorption patterns of the anterior portion of the femoral head.</p><p><strong>Level of evidence: </strong>Level III, prognostic study.</p>\",\"PeriodicalId\":56060,\"journal\":{\"name\":\"Journal of Childrens Orthopaedics\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/72/10.1177_18632521231164985.PMC10242379.pdf\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Childrens Orthopaedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1177/18632521231164985\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Childrens Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/18632521231164985","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Prognostic value of bone resorption pattern in the anterior portion of the femoral head in Legg-Calvé-Perthes disease.
Purpose: To examine whether differences in bone resorption patterns in the anterior portion of the femoral head correlate with the prognosis of Legg-Calvé-Perthes disease.
Methods: Seventy-eight patients with unilateral Legg-Calvé-Perthes disease, who were diagnosed after 6.0 years of age, underwent the Salter innominate osteotomy from 1987 to 2013, and were followed up to skeletal maturity. The anterior bone resorption pattern of the femoral head was evaluated from a frog-leg lateral hip radiograph made in the middle of the fragmentation period, and classified into two types, an epiphysis-preserved type (P) and a physis-disrupted type (D). The correlation between the type of bone resorption and the Stulberg outcome was analyzed.
Results: The Stulberg outcomes were grade I for 9 patients, grade II for 31, grade III for 35, and grade IV for 3, with a mean follow-up period of 8.3 ± 2.7 years. Fifty-one patients demonstrated the type P hips and 27 did the type D hip. In a subset analysis of patients with the modified lateral pillar group-B hips in the younger group (6.0-8.9 years of age at diagnosis), the percentages of the favorable and unfavorable outcomes significantly differed between the two types (p = 0.013). Anteroposterior enlargement of the affected femoral head was significantly greater in the type D hips than the type P hips (p = 0.014).
Conclusion: Unfavorable hip morphology at skeletal maturity can be predicted in patients with the lateral pillar group-B hips by focusing on bone resorption patterns of the anterior portion of the femoral head.
期刊介绍:
Aims & Scope
The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery.
It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents.
The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology.
The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.