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Innominate Osteotomy for Perthes' Disease

Summary: Seventy children who underwent innominate osteotomy for Perthes' disease were reviewed. They had been subjected to this surgery because they were considered to have a poor prognosis as indicated by age, Catterall grading, and by the presence of uncovering of the femoral head. The period of follow-up ranged from 2 to 11 years and averaged 4.3 years. The clinical results were satisfactory. The radiological results were graded (using the Sundt criteria) as good in 54%, fair in 19%, and poor in 27%. Seven children developed postoperative stiffness sufficient to require hospitalization; usually these and the children with a poor result had been subjected to late surgery and had significant hip irritability or femoral head deformity preoperatively. Based on this analysis, our indication for innominate osteotomy is for a child, over the age of 6 years, with the greater part of the femoral head affected by the disease and uncovering of the femoral head. The surgery should be performed within 8 months of presentation.