{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T03:10:48Z","timestamp":1777864248859,"version":"3.51.4"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study aimed to evaluate the long-term radiographic outcomes of containment surgery in children with Legg\u2013Calv\u00e9\u2013Perthes disease (LCPD) during the reossification stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 58 children diagnosed with Waldenstr\u00f6m stage III LCPD. Patients were divided into a non-surgical group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923, mean age 8.56\u2009\u00b1\u20091.74\u2005years) and a surgical group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935, mean age 8.28\u2009\u00b1\u20091.29\u2005years). All patients were monitored with serial anteroposterior pelvic and frog-leg lateral radiographs. At the final follow-up, femoral head morphology was assessed using the modified Stulberg classification, while acetabular development was evaluated using the modified T\u00f6nnis angle and the acetabular head index (AHI).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      All 58 patients were followed until skeletal maturity. The mean follow-up duration was 7.15\u2009\u00b1\u20092.68\u2005years in the non-surgical group and 11.94\u2009\u00b1\u20095.31\u2005years in the surgical group. At final follow-up, in the surgical group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200935), the simplified three-group modified Stulberg classification showed 34.3% Class I (Excellent; Stulberg I\u2013II), 51.4% Class II (Good; Stulberg III), and 14.3% Class III (Poor; Stulberg IV\u2013V). In the non-surgical group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200923), the corresponding proportions were 17.4%, 43.5%, and 39.1%, respectively. Although a trend toward more favorable outcomes was observed in the surgical group, the difference in the proportion of acceptable outcomes did not reach statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.057, OR\u2009=\u20093.857). However, the surgical group exhibited a significantly smaller modified T\u00f6nnis angle (6.12\u00b0\u2009\u00b1\u20096.27\u00b0 vs. 11.63\u00b0\u2009\u00b1\u20095.73\u00b0,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.002) and a higher AHI (86.98%\u2009\u00b1\u20098.99% vs. 75.51%\u2009\u00b1\u20096.70%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), indicating superior acetabular morphology and coverage.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Containment surgery performed during the reossification stage of LCPD was associated with significantly better acetabular morphology and coverage and showed a trend toward improved femoral head sphericity. These findings suggest that surgical intervention may be beneficial in select patients with LCPD during this stage of the disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1826534","type":"journal-article","created":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:38:56Z","timestamp":1777527536000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term radiographic outcomes following containment surgery for Legg\u2013Calv\u00e9\u2013Perthes disease in the reossification stage"],"prefix":"10.3389","volume":"14","author":[{"given":"Huadong","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatric Orthopedics, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Boxiang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Trauma Orthopedics and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Guangxi, Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhe","family":"Fu","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianping","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianwei","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Trauma Orthopedics and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Guangxi, Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shijie","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Trauma Orthopedics and Hand Surgery, The First Affiliated Hospital of Guangxi Medical University","place":["Guangxi, Nanning, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhongli","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pediatric Orthopedics, Tianjin Hospital","place":["Tianjin, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,30]]},"reference":[{"key":"B1","first-page":"93","article-title":"Legg\u2013Calve\u2013Perthes syndrome (LCPS). 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