No full-text available
To read the full-text of this research,
you can request a copy directly from the author.
A physical therapy approach to Legg-Calvé-Perthes in children submetted to artrodistractor equipment: a case study
ResearchGate has not been able to resolve any citations for this publication.
Eleven hips of 11 patients (8 boys, 3 girls; mean age, 7.5 years) with a diagnosis of Perthes disease underwent distraction using an Ilizarov external fixator. All patients had one or more Catterall signs of poor prognosis, with four hips classified as Herring class B and seven as class C. Patients were followed for a mean of 36 months. Average time for wearing the fixator was 99 days (range, 40-150 days). After fixator removal, containment was lost in two more patients and was sustained in only four patients. The most common complication was pin track infection, which occurred in eight patients. The low rate of success found does not justify the routine use of this technique.
We studied the natural history of Perthes' disease in 62 children in whom the onset of symptoms was in adolescence. Three patterns of disease were noted, namely, late-onset pattern, segmental collapse, or destructive with failure of revascularisation. In the late-onset pattern, the disease followed the sequence of healing seen in younger children, but adequate epiphyseal remodelling did not occur. Consequently, the femoral head was never spherical after revascularisation. With segmental collapse, early and irreversible collapse of part of the epiphysis occurred with gross deformation of the femoral head. The destructive pattern was characterised by a failure of revascularisation and repair of the avascular epiphysis. The radiological outcome was poor in all three patterns. The poorest clinical results were found in the destructive type which was frequently associated with incapacitating pain requiring arthrodesis or excision arthroplasty within three years of onset of the disease.
An analysis of 5 methods of treatment for Legg-Calvé-Perthes disease was done on 124 patients with 141 affected hips. Before treatment, all groups were statistically similar concerning initial Mose measurement, age at onset of the disease, gender, and Catterall class. Treatments included the Scottish Rite orthosis (41 hips), nonweight bearing and exercises (41 hips), Petrie cast (29 hips), femoral varus osteotomy (15 hips), or Salter osteotomy (15 hips). Hips treated by the Scottish Rite orthosis had a significantly worse Mose measurement across time interaction (repeated measures analysis of variance, post hoc analyses, p < 0.05). For the other 4 treatment methods, there was no statistically different change. At followup, the Mose measurements for hips treated with the Scottish Rite orthosis were significantly worse than those for hips treated by nonweight bearing and exercises, Petrie cast, varus osteotomy, or Salter osteotomy (repeated measures analysis of variance, post hoc analyses, p < 0.05). There was, however, no significant difference in the distribution of hips according to the Stulberg et al classification at the last followup.
Ortope-día pediátrica
- Gd Maceren
- Wp Bunnell
- Ramsey
In: Maceren GD, Bunnell WP, Ramsey PL. Ortope-día pediátrica. Buenos Aires: Panamericana; 1986
3.Santili C Doença de Legg-Perthes-Calvé Ortopedia e Traumatologia: princípios e prática. 2
- S Herbert
- Xavier
p.2076- 84. 3.Santili C. Doença de Legg-Perthes-Calvé. In: Herbert S, Xavier R et al. Ortopedia e Traumatologia: princípios e prática. 2.ed. Porto Alegre: Artmed; 2003. p.305-20
Tratamento da forma ativa da doença de Legg-Calvé-Perthes pela artrodiástase. Rev Bras Ortop
- Jb Volpon
- Rs Lima
- Ac Shimano
Volpon JB, Lima RS, Shimano AC. Tratamento da
forma ativa da doença de Legg-Calvé-Perthes pela
artrodiástase. Rev Bras Ortop 1998 Jan.; 33(1): 8-14.
Desenvolvimento de fixador externo para aplicação de artrodiástase com tratamento de
- Rs Lima
Lima RS. Desenvolvimento de fixador externo para
aplicação de artrodiástase com tratamento de
Doença de Legg-Calvé- Perthes: afecções do quadril; diagnóstico e tratamento atual em ortopedia traumatologia. São Paulo: Lemos; 1999. fasc.1
- Godoy Jr
- Rm
- Mcm Luzo
Godoy Jr. RM, Luzo MCM. Doença de Legg-Calvé-
Perthes: afecções do quadril; diagnóstico e tratamento atual em ortopedia traumatologia. São Paulo:
Lemos; 1999. fasc.1. p.6-16.
Lovell and Winter's Pediatric Orthopaedics 5
- Sl Weinstein
- Legg-Calvé-Perthes
- Syndrome
Weinstein SL. Legg-Calvé-Perthes Syndrome. In:
Morrissy RT, Weinstein SL (eds.) Lovell and Winter's
Pediatric Orthopaedics 5.ed. Philadelphia: Lippincott
Williams & Wilkins; 2001. v.2. p.?-?.
The hip In: Behman N. Textbook of Pediatrics
- N Behman
Behman N. The hip. In: Behman N. Textbook of
Pediatrics. 16.ed. Philadelphia: Saunders; 2000.
p.2076-84.
Manual de goniometria. São Paulo: Manole
- Ap Marques
Marques AP. Manual de goniometria. São Paulo:
Manole; 2004.
Músculos: provas e funções. São Paulo: Manole
- Fp Kendall
- Ek Mccreary
- Pg Provance
Kendall FP, McCreary EK, Provance PG. Músculos:
provas e funções. São Paulo: Manole; 1995.
Ortopedia de Turek: princípios e suas aplicações. São Paulo: Manole
- Sl Weinstein
- Sl Quadril Pediátrico Weinstein
- Ja Buckwalter
Weinstein SL. Quadril pediátrico. In: Weinstein SL,
Buckwalter JA. Ortopedia de Turek: princípios e
suas aplicações. São Paulo: Manole; 2000.