الفهرس 
Historical BackgroundOnly 14 pages are availabe for public view
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Abstract
Perthes’disease of 20 hips in 20 patients had been treated between 1989 and 1993, 16 hips were treated by femoral varus
derotational osteotomy, 2 hips by Salter innominate osteotomy and
2 hips by combined osteotomy femoral and Salter ). The
prerequisities for innominate osteotomy were only fulfilled in 2
cases and we found either procedure alone was not adequate in 2
cases ( in which combined osteotomy was performed ).
All cases were sUbjected to through clinical, radiological and
laboratory examination.
The indications for surgical containment were : children older
than 6 years old, Catterall group II, III or IV and at - risk. 19
hips had had lateral subluxation of the femoral.head ( which is the
mo£t important at-risk sign ).
At the end of follow up, radiological findings revealed that
the coverage of the femoral head was markedly improved as assessed
by C- E angle. According to the measuring the sphericity of the
femoral head by using the concentric circles of Mose, satisfa~tory
results were obtained following surgical containment. Good results
were obtained in 50% of cases; fair results in 35%, while poor
results were obtained in 15% of cases cases grouped together ).
The results of femoral osteotomy were 56% good; 31% fair and 13%
poor.
The clinical evaluation had been done for all cases based on
the range of motion of the hips, limb shortening and gait disorders
giving a higher proportion of good results. Same observation was
reported by others. The maximum amount of shortening was 2 em
( not functionally disabling I. Trendlenburg’s test and gait was
posi tive in only 3 cases (15% I. On studying the range of hip
motion,the patients showed little functional disability following
operative treatment ( 60% good; 25% fair; and 15% poor ).
The results for patients aged below 9 years were much better
than those obtained in older children. Also, the chances of good
results steadily decreased from Catterall group II to group IV. as
well as, high incidence of good and fair results were detected when
the epiphyseal extrusion index was less than 20 per cent.
It is important to emphasized that the early results of
containment osteotomies were enCouraging but a longer follow up
period should be awaited to confirm these results and to evaluate
the role of these osteotomies to prevent or to delay the late
degenerati ve arthritis in the hip joints affected by Perthes’
disease.