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DOI: 10.1055/s-0042-1758365
Femoral Head Reduction Osteotomy for Legg-Calvé-Perthes Disease Sequelae: Case Report
Article in several languages: português | EnglishFinancial Support The authors declare not having received any financial support from either public, commercial, or not-for-profit sources.
Abstract
Legg-Calvé-Perthes disease (LCPD) commonly causes sequelae in the hip joint morphology. A common variant is an oversized, nonspherical femoral head, associated with a short femoral neck and elevated greater trochanter, which leads to femoroacetabular impingement (FAI). The innovative Ganz technique for surgical hip dislocation opened up new treatment possibilities for FAI, including LCPD sequelae, without increasing the risk of avascular necrosis of the femoral head. In the ellipsoid coxa magna resulting from LCPD, joint wear is more accentuated in the central portion of the femoral head; the lateral third remains intact as it does not articulate with the acetabulum. A femoral head reduction osteotomy technique developed for such cases resects the damaged portion of the femoral head and restores its sphericity. Short-term outcomes are encouraging. The present case report presents a patient with LCPD sequelae submitted to a femoral head reduction osteotomy.
Study carried out at the Department of Orthopedics and Traumatology Centro Hospitalar Tondela-Viseu, Viseu, Portugal.
Publication History
Received: 14 March 2022
Accepted: 12 September 2022
Article published online:
31 July 2023
© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)
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Referências
- 1 Tannast M, Macintyre N, Steppacher SD, Hosalkar HS, Ganz R, Siebenrock KA. A systematic approach to analyse the sequelae of LCPD. Hip Int 2013; 23 (9, Suppl 9) S61-S70
- 2 Wenger DR, Hosalkar HS. Principles of treating the sequelae of Perthes disease. Orthop Clin North Am 2011; 42 (03) 365-372 , vii
- 3 Aprato A, Pellegrino P, Kain MSH, Masse A. Do osteotomies of the proximal femur still have a role?. Curr Rev Musculoskelet Med 2014; 7 (04) 323-329
- 4 Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br 2001; 83 (08) 1119-1124
- 5 Novais EN, Clohisy J, Siebenrock K, Podeszwa D, Sucato D, Kim Y-J. Treatment of the symptomatic healed Perthes hip. Orthop Clin North Am 2011; 42 (03) 401-417 , viii
- 6 Ganz R, Huff TW, Leunig M. Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application. Instr Course Lect 2009; 58: 241-255
- 7 Ganz R, Horowitz K, Leunig M. Algorithm for femoral and periacetabular osteotomies in complex hip deformities. Clin Orthop Relat Res 2010; 468 (12) 3168-3180
- 8 Paley D, Feldman DS. Femoral Head Reduction Osteotomy. In: Hamdy RC, Saran N, editors. Pediatric pelvic and proximal femoral osteotomies. Toronto, Canadá: Springer International Publishing; 2018: 379-420
- 9 Paley D. The treatment of femoral head deformity and coxa magna by the Ganz femoral head reduction osteotomy. Orthop Clin North Am 2011; 42 (03) 389-399 , viii
- 10 Siebenrock KA, Anwander H, Zurmühle CA, Tannast M, Slongo T, Steppacher SD. Head reduction osteotomy with additional containment surgery improves sphericity and containment and reduces pain in Legg-Calvé-Perthes disease. Clin Orthop Relat Res 2015; 473 (04) 1274-1283