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題名 | Surgical Treatment of Severe Perthes Disease: Comparison of Triple Osteotomy and Shelf Augmentation=重度帕氏症之外科治療:三位式截骨術和蓋頂加強術之比較 |
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作者 | 黃盟仁; 黃世傑; | 書刊名 | 臺灣醫學會雜誌 |
卷期 | 98:3 1999.03[民88.03] |
頁次 | 頁183-189 |
分類號 | 416.26 |
關鍵詞 | 重度帕氏症; 三位式截骨術; 蓋頂加強術; Perthes disease; Triple innominate osteotomy; Acetabular augmentation; |
語文 | 英文(English) |
英文摘要 | The optimal management of the severe form of Perthes disease is controversial. This retrospective study evaluated the results of two procedures in two groups of patients with Perthes disease. The Catterall classification was adopted for grouping of patients before treatment. The Herring classification was used for comparison of the follow-up radiographs. Under the concept of surgical containment, triple innominate osteotomy was performed in 14 patients at an average age of 8 years 7 months with a mean follow-up period of 4 year 3 months. Staheli's shelf augmentation was performed in 14 patients at an average age of 10 years 2 months with a follow-up period of 3 years 8 months. Radiologically, femoral head subluxation, acetabular coverage, acetabular angle, and center- edge angle were markedly improved in both groups. In the clinical evaluation using modified Sundt's criteria, both procedures were effective Satisfactory results were achieved in 79% of 14 patients (5 good, 6 fair, and 3 poor) in the triple osteotomy group, and 100% of 14 patients (two good, 12 fair) in the shelf augmentation group. Nevertheless, triple innominate osteotomy is technically more demanding with a longer operating time and resulted in more complications. Staheli's shelf augmentation is a simpler procedure with better coverage of the acetabulum. However, asphericity of the femoral heads was observed more frequently in this group. The Herring lateral pillar classification was better than the Catterall classification in predicting the final outcomes in this study. |
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