Volume : 5, Issue : 7, July - 2016

RETROSPECTIVE AND PROSPECTIVE STUDY OF THE ROLE OF ISCHIAL WEIGHT BEARING ORTHOSIS IN PERTHES� HIP

Dr. Sanjai Singh, Dr. Dileep Kumar, Prof. V. P. Sharma, Dr. Anil Kumar Gupta, Dr. Ganesh Yadav, Dr. Sudhir R Mishra, Dr. Javed Ahmad

Abstract :

<p>&nbsp;Background: Legg Calves Perthes disease (LCPD) is a disease of the hips in young children characterized by varying degrees of the avascular necrosis of the femoral ossific nucleus. Aim of treatment is containment of femoral head in acetabulum and to remove deforming mechanical pressure from the joint during the disease course. Objective: Aim of this study was to determine the effect of Ischial Weight Bearing orthosis in perthes disease. Materials and Methods: This Retrospective and open ended Prospective study was done on patients treated for LCPD. Clinical examination and interviews conducted at time intervals of three months, 6 months and one year to assess the various parameters like Range of motion, Trendelenburg sign, Mose grading, Stulberg grading and Reimer Migration Index. Results: 20 patients were enrolled in this study with mean age of onset of symptoms 9.65 years of which 15 (75%) were male and 5 (25%) were female. Right sided hip joint involvement was seen in 9 cases (45%) while left side in 11 cases (55%). Trendelenburg sign was found to be positive in all patients at initial evaluation which decreased to 40 % of cases at 1 year. Mean Hip flexion range improved by 23.00&plusmn;5.33&deg;, abduction by 22.67&plusmn;5.77&deg;, internal rotation by 19.0&plusmn;5.0&deg;, but no significant change was seen in external rotation and extension. Change of grade in Mose grading by atleast one grade was seen in 20 % of patients. Grade change in Stulberg classification categories was seen in 20 % at the end of 1 year follow up. Reimer&rsquo;s migration index change was insignificant. Conclusion: Our study presents favourable results with Ischial weight bearing orthosis. Ischial weight bearing orthosis can be regarded as a salvage method for Perthes‘ disease providing improved range of motion and symptomatic improvement in patients due to pain relief and improvement in gait.</p>