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Femoral osteotomy to improve range of motion in residual deformity of perthes disease: A case report

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Title: Femoral osteotomy to improve range of motion in residual deformity of perthes disease: A case report
Authors: Matsubayashi, Shohei / Chiba, Ko / Tsujimoto, Ritsu / Osaki, Makoto / Wada, Akifusa
Issue Date: 11-May-2020
Publisher: Elsevier Ltd.
Citation: Annals of Medicine and Surgery, 55, pp.5-8; 2020
Abstract: Introduction: The treatment strategies for residual deformity of Perthes disease are not established. Case presentation: This is a case report of a 15-year-old boy. He developed right Perthes disease (lateral pillar classification group B) when he was 10 years old and underwent varus femoral osteotomy of the right side. At 12 years of age, he developed left Perthes disease (lateral pillar classification group B) and underwent varus femoral osteotomy of the left side. Postoperatively, he was treated with partial weight bearing of the left leg with crutches. At 15 years, range of motion (ROM) of his left hip was markedly limited at 30° flexion, 10° abduction, 70° external rotation, and −20° internal rotation, and he was having difficulty maintaining a sitting position. Diagnosis: Stulberg group V was noted on plain radiography. Computed tomography (CT) showed collapse of the load-bearing part of the femoral head on the coronal plane, but the ball-shape was maintained in the posterior femoral head on sagittal and transverse sections. Intervensinos: Valgus-flexion-internal rotation osteotomy was performed to improve ROM. Outcomes: Left hip ROM improved to 90° flexion, 20° abduction, 50° external rotation, and 40° internal rotation immediately after the surgery. He was able to sit 10 months postoperatively but was left with a limp and limited ROM in the left hip at 60° flexion. Chondroplasty was performed during the plate removal surgery at 10 months postoperatively, which improved hip flexion to 100° immediately after the surgery. The patient was left with limited ROM of 60° flexion of the left hip at the final observation. Conclusion: Femoral osteotomy to improve ROM could be an option for residual deformity of Perthes disease.
Keywords: Perthes disease / Residual deformity / 3DCT simulation / Valgus-flexion-internal rotation osteotomy / Case report
URI: http://hdl.handle.net/10069/40003
ISSN: 20490801
DOI: 10.1016/j.amsu.2020.04.031
Rights: © 2020 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/BY/4.0/).
Type: Journal Article
Text Version: publisher
Appears in Collections:Articles in academic journal

Citable URI : http://hdl.handle.net/10069/40003

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