Prognostic factors for trochanteric overgrowth after containment treatment in Legg-Calvé-Perthes disease.
Prognostic factors for trochanteric overgrowth after containment treatment in Legg-Calvé-Perthes disease.
复制标题
Legg-Calvé-Perthes 病遏制治疗后转子过度生长的预后因素。
DOI：
10.1097/bpb.0b013e32835f585b
复制
发表时间：
2013
影响因子：
1.1
通讯作者：
Ishiguro N
中科院分区：
文献类型：
--
作者：
Kitoh H;Kaneko H;Mishima K;Matsushita M;Ishiguro N
转子过度生长是Legg-Calvé-Perthes病治疗后的主要残留畸形之一。本研究旨在确定该疾病患者骨骼成熟时粗隆过度生长的预测因素。回顾性分析了45例在我们机构接受遏制疗法治疗的Legg-Calvé-Perthes病患者的病历和X线照片。进行单变量分析以确定转子过度生长的预测因素，连续变量采用Mann-Whitney U检验，分类变量采用Pearson检验。使用逻辑回归分析确定独立的多变量预测因子。在10名患者（22%）中观察到转子过度生长，定义为关节转子距离小于+ 5 mm。最终Stulberg结局与转子过度生长之间存在强相关性（P= 0.0003）。在单变量和多变量分析中，外侧柱高度是骨骼成熟时转子过度生长的唯一统计学显著预测因素。外侧支柱C髋关节（44%）发生转子过度生长的风险远高于外侧支柱B或B/C髋关节（10%）。对于外侧柱高度降低的患者，有必要进行仔细的随访，以便早期决定是否进行预防性大转子骺固定术。
Trochanteric overgrowth is one of the major residual deformities after the treatment of Legg–Calvé–Perthes disease. The present study was designed to determine the predictive factors for trochanteric overgrowth at skeletal maturity in patients with the disease. Medical records and radiographs of 45 Legg–Calvé–Perthes disease patients who were treated with containment therapy at our institution were reviewed retrospectively. Univariate analysis was carried out to determine the predictors for trochanteric overgrowth using the Mann–Whitney U-test for continuous variables and the Pearson test for categorical variables. Independent multivariate predictors were identified using logistic regression analysis. Trochanteric overgrowth, defined as articulotrochanteric distance less than+ 5 mm, was observed in 10 patients (22%). There was a strong correlation between the final Stulberg outcome and trochanteric overgrowth (P= 0.0003). Lateral pillar height was the only statistically significant predictor for trochanteric overgrowth at skeletal maturity in univariate and multivariate analyses. The risk for the development of trochanteric overgrowth was much greater in the lateral pillar C hip (44%) than in the lateral pillar B or B/C hip (10%). For the patients with decreased lateral pillar height, a careful follow-up is necessary to make an early decision of prophylactic epiphyseodesis of the greater trochanter.