The goal of intervention in Legg-Calvé-Perthes disease has been to prevent femoral head deformation by containing the head within the acetabulum, using it as a mold for guiding femoral head development. With appropriate proximal femoral morphology, premature arthritis can hopefully be avoided. Both nonsurgical and surgical methods of treatment have evolved over time, from abduction casts and braces to advanced surgical containment methods, which are now the mainstay of treatment. The purpose of this study is to briefly review the evolution of surgical treatment of Legg-Calvé-Perthes disease, and to concentrate on 2 advanced surgical containment methods: combined Salter innominate osteotomy with femoral varus osteotomy and triple pelvic osteotomy.
Level of Evidence: Level V.
Department of Orthopaedic Surgery, Rady Children's Hospital San Diego
The University of California-San Diego, San Diego, CA
None of the authors received financial support for this study.
The authors declare no conflict of interest.
Reprints: Dennis R. Wenger MD, Department of Orthopaedic Surgery, 3030 Children's Way, Suite 410, San Diego, CA 92103. e-mail: OrthoEdu@rchsd.org.