Pitfalls in treatment of Legg-Calvé-Perthes disease using proximal femoral varus osteotomy.

Abstract

A femoral varus osteotomy can be used to contain the femoral head in Legg-Calvé-Perthes (LCP) disease if certain pitfalls can be avoided. We reviewed 74 patients who underwent 79 femoral varus osteotomies. The study addressed the pitfalls that should be avoided with this technique. It was concluded that the amount of varus angulation should barely position the femoral head beneath the lateral rim of the acetabulum, avoiding varus less than 105 degrees, and that consideration should be given to performing a greater trochanteric epiphysiodesis at the time of initial femoral osteotomy. The short-term results reflect a positive attitude toward femoral varus osteotomy in treatment of LCP if these pitfalls can be avoided.