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Flashcards in Perthes Deck (7)
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1
Q

poor Prognostic variables for LCP:

A
  • asphericity of the femoral head and congruency at maturity
  • age >6 years at presentation
  • decreased hip ROM/adduction contracture
  • obesity
  • longer duration of the healing cycle
2
Q

Waldenstrom’s 4 stages

A

Initial - infarction, radiographically occult

Fragmentation - dissolving femoral head 2/2 revasc process (most symptomatic)

Reossification- necrotic bone resorbed by creeping substitution (can last 18mo)

Healing/Remodeling - remodeling until skeletal maturity

3
Q

Lateral Pillar (Herring) Classification

A

determine at beginning of fragmentation stage

A: full height, good outcomes

B: >50% height, poor outcome if >6yo

B/C: ~50% height

C: <50% height, poor outcomes in all

4
Q

Stulberg Classification

A

rating residual femoral head deformity and joint congruence

Normal, Ovoid, Flat
Staged I-V

5
Q

Earliest radiographic finding of LCP?

A

medial joint space widening (during the initial stage)

6
Q

Indications for Non-Op Treatment

A

children <8 years
lateral pillar A

bracing/casting have no role

60% of patients do not require surgery

7
Q

Operative indications

A

> 8 years of age
Lateral pillar B and B/C
- femoral varus osteotomy
- pelvic osteotomy