{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,23]],"date-time":"2026-02-23T12:23:32Z","timestamp":1771849412444,"version":"3.50.1"},"reference-count":43,"publisher":"SLACK, Inc.","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:p>It is hypothesized that the interruption of the blood supply is an important factor causing femoral head osteonecrosis in the early stages of Legg-Calv\u00e9-Perthes disease. Currently, treatment by containment is recommended to direct and guide remodeling of the softened femoral head as it evolves from fragmentation through ossification. The goal of this study was to show the results of arthrodiatasis to induce height recovery of the femoral head and to achieve true ambulatory nonweight-bearing containment.<\/jats:p>\n          <jats:p>Forty-two patients younger than 8 years with a diagnosis of Perthes' disease were studied. Twenty-three patients (9 class B and 14 class C according to Herring's classification) were treated with an articulated distraction technique and 19 patients (11 class B and 8 class C) were treated conservatively as a control group. Arthrodiatasis or articulated distraction of the hip combines off-loading of muscles and body forces with distraction of the joint space by means of an external fixator that crosses the hip joint. Radiologically, 21 patients (91%) had satisfactory results and 2 (9%) had unsatisfactory results. Clinically, the results were good in 21 patients (92%), fair in 1 (4%), and poor in 1 (4%). In patients treated conservatively, 14 patients (72%) had satisfactory results and 5 (28%) had unsatisfactory results. Clinically, 71% had good results, 17% had fair, and 12% had poor.<\/jats:p>\n          <jats:p>We conclude that hip joint containment by articulated arthrodiatasis (plus adductors and psoas minimal tenotomy surgery) is an effective method in the management of Perthes' disease in patients younger than 8 years, classified B and C, and associated with a highly reduced range of abduction. Restoration of clinical abnormalities and satisfactory radiological parameters are achieved in high percentages.<\/jats:p>","DOI":"10.3928\/01477447-20090922-15","type":"journal-article","created":{"date-parts":[[2009,11,11]],"date-time":"2009-11-11T18:27:20Z","timestamp":1257964040000},"page":"817-823","source":"Crossref","is-referenced-by-count":14,"title":["Arthrodiatasis for the Treatment of Perthes' Disease"],"prefix":"10.3928","volume":"32","author":[{"given":"Tarek A.","family":"Aly","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osama A.","family":"Amin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2308","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197254010-00012"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198909000-00028"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/01241398-200103000-00013"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198007000-00004"},{"key":"e_1_3_1_6_2","first-page":"273","article-title":"Barrier to material transfer at the bone-cartilage interface: measurement with hydrogen gas in vivo","volume":"145","author":"Ogata K","year":"1979","unstructured":"Ogata K, Whiteside LA. 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Lateral acetabular growth stimulation following a labral support procedure in Legg-Calve-Perthes disease. J Bone Joint Surg Am. 2006; 88(7):1458\u20131466.","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"e_1_3_1_21_2","first-page":"740","article-title":"Comparison of radiological results of conservative and operative treatment by Salter osteotomy in severe cases of Perthes' disease","volume":"6","author":"Kacki W","year":"2004","unstructured":"Kacki W, Zarzycka M, Zarzycki D, . Comparison of radiological results of conservative and operative treatment by Salter osteotomy in severe cases of Perthes' disease. Ortop Traumatol Rehabil. 2004; 6(6):740\u2013747.","journal-title":"Ortop Traumatol Rehabil"},{"issue":"6","key":"e_1_3_1_22_2","first-page":"697","article-title":"Remodelling and congruency of the hip joint in children with Perthes' disease treated with varusderotation subtrochanteric osteotomy","volume":"6","author":"Kolban M","year":"2004","unstructured":"Kolban M, Darczuk J, Chmielnicki M. Remodelling and congruency of the hip joint in children with Perthes' disease treated with varusderotation subtrochanteric osteotomy. Ortop Traumatol Rehabil. 2004; 6(6):697\u2013704.","journal-title":"Ortop Traumatol Rehabil"},{"issue":"6","key":"e_1_3_1_23_2","first-page":"751","article-title":"The effect of the therapeutic approach on the course of Perthes' disease and its outcome: Conservative vs. surgical treatment","volume":"6","author":"Pietrzak S","year":"2004","unstructured":"Pietrzak S, Napiontek M, Kraiz S. 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Ilizarov fixator for treatment of Legg-Calv\u00e9-Perthes disease. J Pediatr Orthop B. 1999; 8(4):276\u2013281.","journal-title":"J Pediatr Orthop B"},{"key":"e_1_3_1_34_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503260066"},{"key":"e_1_3_1_35_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11832-007-0007-7"},{"issue":"3","key":"e_1_3_1_36_2","first-page":"222","article-title":"Legg-Calv\u00e9-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","volume":"12","author":"Fabry K","year":"2003","unstructured":"Fabry K, Fabry G, Moens P. Legg-Calv\u00e9-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. 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