Musculoskeletal Key

Coxa brevis of the hip results in a morphologic change of the proximal femur creating pain and fatigue, leg-length discrepancy, and altered gait. The most common cause is a growth…

The aspherical coxa magna femoral head can be made more spherical by intra-articular osteotomy. The Ganz technique of femoral head reduction osteotomy to reduce the size and restore the spherical…

Standard surgical approaches for Perthes disease consist of nonoperative physical treatments or surgical treatment. Several investigators have been working on a better understanding of the pathophysiology and pathobiology of Perthes…

Despite early treatment efforts, many patients with Perthes disease are left with residual femoral head deformity, which can be symptomatic with a residual limp and poor hip motion. Many such…

Hinge abduction occurs early in the fragmentation stage of Legg-Calvé-Perthes disease and should be suspected when abduction and internal rotation are lost. It can be confirmed by an AP radiograph…

Articular hip distraction can be applied either by using a monolateral articulated distractor or a circular fixator. The fixator should be aligned such that its axis is aligned with the…

Failure of the enlarged and deformed anterolateral portion of the femoral head to roll into the acetabulum during abduction alters hip joint mechanics. The resultant hinge abduction is associated with…

It is of paramount importance to distinguish hips that may or may not be suitable for containment in the transitional stage (fragmentation to early reossification stage), because long-term clinical and radiological…

The objective of containment treatment in Perthes disease is to hold the femoral head in the acetabulum during the period of “biologic plasticity” while necrotic bone is resorbed and living…

The aim of treatment of Perthes in the early part of the disease is to prevent the femoral head from getting deformed by muscular forces and weight-bearing stresses transmitted across…