Radiological Follow-up and Prognosis of Legg-Calve-Perthes Diseases.

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In 1992 J. A. Herring et al. reported that lateral pillar classification based on radiographic data could predict the outcome of Legg-Calve-Perthes disease. Lateral pillar was defined as the lateral remainder of the epiphysis in its fragmentation stage. The lateral pillars were compared to their contralateral femoral heads and then classified into three groups. Group A: non-involvement of the lateral pillar, Group B: >50% of lateral pillar height maintained and Group C: <50% of lateral pillar height upheld. Final radiographs were reviewed at skeletal maturity and the outcome was determined according to the Stulberg classification system.At Beppu Development and Habilitation Center the hip radiographs of 42 Perthes patients whose femoral head remodellings were completed were classified according to the J. A. Herring method. We then examined the predictability of Herring's classification. Our results were as follows: Group A had four Stulberg I and three Stulberg II patients with good results. Group B had 13 Stulberg II, three Stulberg I, four Stulberg III and one Stulberg IV patients. In Group C there were poor results with eight Stulberg III, five Stulberg IV and only one Stulberg II patients. We concluded that Herring's pillar classification was useful in predicting the outcome of Legg-Calve-Perthes disease.
西日本整形・災害外科学会の論文