Bony Changes of the Proximal Femur in Legg-CalvÃ©-Perthes Disease: Comparison between disease healing stage and skeletal maturity

Rowe, Sung Man; Yoon, Taek Rim; Jung, Sung Taek; Park, Jae Hyung

Abstract

Generally the clinical results of Legg-CalvÃ©-Perthes disease were evaluated until the time of disease healing. However, it is well known that the deformities of the proximal femur progress to the period of skeletal maturity. The purpose of this study was to evaluate the progression of the deformities in the proximal femur. In a retrospective study of 60 patients with Legg-CalvÃ©-Perthes disease, who visited Chonnam National University Hosipital 1974 and 1995 and who were followed until the skeletal maturity, the bony changes of the proximal femur were compared between disease healing stage and skeletal maturity. The results were as follow; 1. More bony deformities were identified in skeletal maturity than in disease healing. 2. The quotient of inferior border of medial femoral neck decreased from 60% in disease healing to 45% in skeletal maturity (P < 0.001). 3. The femoral shortening increased from 4.9mm in disease healing to 10mm in skeletal maturity (P < 0.001). 4. The femoral neck-shaft angle decreased from 128 degrees in disease healing to 125 degrees in skeletal maturity (P < 0.001). 5. The proximal migration of greater trochanter increased from 13.8mm in disease healing to 21.3mm in skeletal maturity (P < 0.001). 6. There were no significant statistical differences in clinical results between operative and conservative treatment groups. 7. The spherical quotient of femoral head and Stulberg rate revealed no differences between disease healing and skeletal maturity. These results revealed that there were considerable differences of the deformities in the proximal femur at the time of disease healing and skeletal maturity.