Add like
Add dislike
Add to saved papers

Legg-calve-perthes disease: a review of cases with onset before six years of age.

BACKGROUND: The prognosis for children in whom Legg-Calvé-Perthes disease develops before the age of six years was initially reported to be good, but later studies demonstrated a less favorable prognosis. To assess the natural history of this condition in this age group, we reviewed a large cohort of children who had received minimal treatment for the disease.

METHODS: The medical records and radiographs of all children with Legg-Calvé-Perthes disease seen at our institution between 1944 and 2000 were reviewed. The cases of 172 patients with a total of 188 affected hips were studied. The course of the disease and the final clinical and radiographic outcomes were evaluated in all patients.

RESULTS: Typical Legg-Calvé-Perthes disease was noted in 164 hips of 160 patients. According to the lateral patellar classification, seven of these hips were in group A; 101, in group B; twenty-seven, in the B/C border group; and twenty-nine, in group C. According to the Stulberg classification, there were 131 Class-I or II (good) results, fourteen Class-III (fair) results, and nineteen Class-IV (poor) results. The lateral pillar classification was highly correlated with the outcome, whereas treatment did not correlate with the outcome. Only lateral pillar group-B/C border and C hips with an onset of the disease between the ages of four years and five years and eleven months had a poor prognosis. We unexpectedly encountered a group of twelve patients with bilateral, simultaneous development of apparent Legg-Calvé-Perthes disease. In that group, there were twenty-one Stulberg Class-I or II (good), three Stulberg Class-III (fair), and no Stulberg Class-IV (poor) results, although fourteen of the twenty-four hips were in lateral pillar group C. The outcome in the hips in lateral pillar group C was significantly better when the patient had bilateral simultaneous involvement than when the patient had typical Legg-Calvé-Perthes disease.

CONCLUSIONS: The prognosis for patients with the onset of Legg-Calvé-Perthes disease before the age of six years is favorable, with 80% having a good result. Only children between the ages of four years and five years and eleven months with a B/C or C lateral pillar classification of involvement have a less favorable prognosis. Treatment was not found to influence outcome. Simultaneous bilateral disease, which had a more favorable prognosis, may represent a unique disorder.

Full text links

We have located links that may give you full text access.
Can't access the paper?
Try logging in through your university/institutional subscription. For a smoother one-click institutional access experience, please use our mobile app.

For the best experience, use the Read mobile app

Mobile app image

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

By using this service, you agree to our terms of use and privacy policy.

Your Privacy Choices Toggle icon

You can now claim free CME credits for this literature searchClaim now

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app