ANALYSIS OF THE RESULTS OF SURGICAL TREATMENTOF LEGG-CALVE-PERTES DISEASE IN CHILDREN

Abstract

Introduction. The current concept of Legg-Calve-Perthes disease is idiopathic necrosis of the proximal femoral
epiphysis, which may be involved in whole or in part. It is characterized by severe anatomical disorders of the hip joint,
leading to functional disorders of the affected lower limb and the entire musculoskeletal system, such pathological conditions as instability, discongruence and anatomical inconsistency. It is the correction of these disorders, along with the restoration
and improvement of function, that is the main goal of surgical treatment.
Purpose of the study. To analyze the surgical treatment in children with Legg-Calve-Perthes disease.
Materials and methods. Retrospective cross-sectional study. A review of the treatment of Perthes disease in children for the
period from January 2011 to December 2018, located at the Department of Pediatric Orthopedics No. 2 of the «University Medical
Center» Corporate Fund, the Department of Orthopedics and Rehabilitation of the City, Clinical Hospital of the City Children's
Hospital No. 2 (Astana), and the Department of Pediatric Surgery of the University Hospital of the Semey Medical University
(Semey). The material of the study was medical documentation Form 003 / y - medical record of an inpatient. To analyze statistically
significant differences in quantitative data with a distribution other than normal, the Mann-Whitney test was used. Differences in
groups of categorical variables were analyzed using the Chisquaretest. Qualitative data are presented as absolute numbers and
percentages. The critical level of statistical significance was set at p <0.05.
Results. The number of operated patients was 20, unilateral lesion in 17 patients, bilateral - in 3. A total of 23 joints were
examined, the age of patients ranged from 8 to 11, Me (mean value) - 9 years with diagnosed Legg-Calve-Perthes disease.
By place of residence, urban patients were 8 (42.1%), rural - 11 (57.9%). Patients received surgical treatment at stages 2-3
of Perthes disease, tunnelization of the femoral head and neck with the introduction of autospongiosis.
Conclusions. We consider the tunnelization of the femoral head and neck with the introduction of autospongiosa to be
effective in children with the initial stage of the disease and a small lesion of the pineal gland, it is advisable to use it as a
method to stimulate blood circulation in the osteonecrosis zone in the early stages of the disease and is the operation of
choice in children in the early stages of Legg-Calve disease - Perthes.