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POSTERIOR PILLAR CLASSIFICATION OF PERTHES DISEASE

Okayama University Medical School, Department Of Orthopaedic Surgery, 2-5-1 Shikata-Cho, Okayama, 700-8558, Japan

The authors added a classification of posterior pillars to Herring’s classification of lateral pillars in a retrospective study of 33 patients with Perthes disease. Anteroposterior and frog position lateral radiographs taken approximately two months later from first visit, were evaluated. All patients were treated by a non-weight-bearing method (continuous traction and wheel chair activity). The outcome was evaluated by the Stulberg method.

The mean age at follow-up was 18 years (range,14.2 to 26.9 years).

Thirteen hips were in Catterall group II, 18 were in group III, and two were in group IV. Twenty-five of the 33 hips were in Stulberg class I or II (with good results), and eight hips were class III. Nine hips were in Herring group A, 20 hips were in group B, and four were in group C. Eleven hips were in our group A with the posterior pillar classification, 16 were in group B, and six were in group C. Group A, with a lateral or posterior pillar had good results without exception. Concerning Herring’s classification, all four heads had become aspherical in group C, however, 16 hips were good results and four hips were poor in group B. The outcome was poorly related to the classification in 20 patients with 20 affected hips in Herring group B when only lateral pillars were used in classification. When both lateral and posterior pillars are considered in classification, results can be predicted more accurately than when only lateral pillars are considered. This more accurate prognosis at an early stage of Perthes disease can facilitate effective treatment selection.

The abstracts were prepared by Professor Jegan Krishnan. Correspondence should be addressed to him at the Flinders Medical Centre, Bedford Park 5047, Australia.