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General Orthopaedics

IS IT POSSIBLE TO TREAT LEGG-CALVÉ-PERTHES DISEASE WITH EXTERNAL FIXATION AND DISTRACTION?

The British Limb Reconstruction Society (BLRS) Annual Meeting 2022, Brighton, England, 24–25 March 2022.



Abstract

Introduction

Despite all modern advances the indications and possibilities of treatment in Legg-Calvé-Perthes Disease (LCPD) are still controversial. In the past 15 years we started using arthrodiastasis of the hip creating negative pressure over the avascular femoral head in some selected cases of LCPD in the active phasis of the disease. Now we present our experience with distraction in LCPD using the original Ilizarov circular frame for the hip.

Materials and Methods

From 2015 to 2021, eight patients with LCPD were submoitted to hip distraction; all male ranging from six to 12 years (avg 8.2 years). All patients with bad prognosis, in Catterall Groups III and IV. All patients in the active phasis of the disease. Our follow-up is ranging from two to six years, with an average of 3.4 years.

Results

All the preliminary results are good with recovering of range of motion of the affected hip joint in allpatients. After the first month under distraction is possible to observe new bone formation specially in the lateral pillar of the femoral head. Complications were not observed in this group of patients.

Conclusions

The main point of this prospective study is to find that is possible to achieve cartilaginous growth on the femoral head stimulated by the traction offered by the external fixator, in a very short period of time. Distraction may be one method for a good treatment in patients aged six years or older with Legg-Calvé-Perthes disease in the active phase of the disease