Volume 11 Issue 3
Evaluating the Radiological Outcomes of Shelf Osteotomy in the Treatment of Legg-Calve-Perthes Disease: A Longitudinal Study
1Ali Raza, 2Nouraiz Shakoor, 3Usama Ali Nawazish, 4Hammad Ali, 5Dr Saba Akram, 6Ahsan Ul haq, 7Kashif Lodhi
1PIMS
2Senior Registrar Orthopaedics, Madinah Teaching Hospital Faisalabad
3Senior Registrar Orthopedic Surgery, THQ Kahna Nau Hospital, Lahore.
4PIMS
5Assistant professor of Radiology, Avicenna medical and dental college Lahore
6Associate Professor, Orthopaedic Surgery, Mohterma Benazir Bhutto Shaheed Medical College Mirpur Azad Kashmir.
7Department of Agricultural, Food and Environmental Sciences. Università Politécnica delle Marche Via Brecce Bianche 10, 60131 Ancona (AN) Italy
Submission March 2024
Acceptance June 2024
Online August 2024.
ABSTRACT
Background: Legg-Calve-Perthes Disease (LCPD) is pediatric orthopedic condition categorized by avascular necrosis of femoral head. Shelf osteotomy has been employed as a surgical intervention aimed at improving hip joint stability and promoting femoral head reformation. The radiological outcomes of this procedure in LCPD patients require further evaluation to establish its efficacy.
Aim: This research aimed to evaluate radiological results of shelf osteotomy in children diagnosed with LCPD over the one-year period.
Methods: A longitudinal study was conducted from December 2022 to December 2023, involving 90 pediatric patients diagnosed with LCPD who underwent shelf osteotomy. Radiographic evaluations were performed preoperatively and at three-month intervals postoperatively. Parameters such as the Stulberg classification, acetabular coverage, and femoral head sphericity were analyzed to determine the success of the surgical intervention.
Results: The study population comprised 90 children (58 boys and 32 girls) having the mean age of 7.5 years at the time of surgery. Postoperative radiographs showed significant improvements in acetabular coverage and femoral head sphericity. By the end of research, 78% of patients achieved Stulberg class I or II outcomes, indicating favorable prognoses. The majority of patients demonstrated progressive femoral head reformation and stability, with minimal complications reported.
Conclusion: Shelf osteotomy proved to be an effective surgical treatment for LCPD, resulting in improved radiological outcomes and enhanced hip joint stability in the majority of the pediatric patients. The procedure was related through high rates of favorable Stulberg classifications and minimal postoperative complications, supporting its continued use in managing LCPD.
Keywords: Legg-Calve-Perthes Disease, Shelf Osteotomy, Pediatric Orthopedics, Radiological Outcomes, Femoral Head Necrosis, Hip Joint Stability.