Legg???Calv?????Perthes disease in patients under 5 years of age does not always result in a good outcome. Personal experience and meta-analysis of the literature

Abstract

This study attempted to analyze objectively the longstanding impression that children under 5 years of age, who have Legg-Calvé -Perthes disease, generally do well. Thirty patients, with 36 hips and onset of disease prior to their fifth birthday were reviewed at skeletal maturity. More than 50% of the hips were classified in Catterall group 3 or 4, and Herring group C. The end evaluation by the Stulberg classification showed 44.5% good, 22.2% fair and 33.3% poor results. By the Mose rating the results were respectively 27.8% good, 30.6% fair and 41.6% poor.A meta-analysis of the literature showed a very broad spectrum of results, leading to the conclusion, first, that comparison is difficult and, second, that young age is not a free ticket to a good result. J Pediatr Orthop B 12:222-228

(iv) Legg Calvé Perthes’ disease

“…This leaves a considerable indeterminate area and Snyder and others have reported poor results even in very young patients with Perthes'. 15,16 Much effort has focused on judging the shape of the femoral head at maturity. Two methods are commonly used, the classification of Stulberg et al and the concentric ring method of Mose 17,18 (Figs.…”