Analysis of Atrophy of Gluteal Maximus and Medius in Perthes' Disease.

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Cross-sectional area of the bilateral gluteus maximus and medius was measured in 10 cases with hemilateral Perthes' disease, using CT scans at the level of the anterior superior iliac spine. The period ofmeasurement from the onset of the disease was 2 months to 3 years and 8 months, and the total number of measurements was 32. The area ratio of the affected/unaffected side was calculated to evaluate the degree of muscle atrophy. We use wheel chairs and abduction braces for non-weight bearing and good containment.We compared the averages between the two groups; group 1) non-weight bearing period using wheel chairs, group 2) more than 12 months after the start of walking. A 6.5% increase was seen in gluteus maximus and 5.5% increase was seen in gluteus medius. Recovery of muscle atrophy was very slow and it tended to need a very long time. 5 cases showed Trendelenburg's sign during the measurement and in 4 of the 5 cases, the sign disappeared within 4 months. In the 5 cases that showed Trendelenburg's sign, the affected/unaffected area ratio in both gluteus medius and maximus was less than 91%.