The Journal of Bone and Joint Surgery, Vol 74, Issue 1 12-21, Copyright © 1992 by Journal of Bone and Joint Surgery, Inc
The weight-bearing abduction brace for the treatment of Legg-Perthes disease
AG Martinez, SL Weinstein and FR Dietz
Department of Orthopaedics, University of Iowa, Iowa City.
We reviewed the cases of thirty-one patients (thirty-four hips) who had had
severe Legg-Perthes disease (Catterall group III, five hips and group IV,
twenty-nine hips) and had been treated with a weight-bearing abduction
orthosis, to determine the effectiveness of the brace. The mean age of the
patients when they were first seen was six years (range, three to twelve
years). The mean duration of follow-up was seven years (range, two to
thirteen years). At the most recent follow-up, all hips were rated with the
method of Mose and the classification of Stulberg et al. According to the
criteria of Mose, no hip had a good result, twelve (35 per cent) had a fair
result, and twenty-two (65 per cent) had a poor result. On the basis of the
classification of Stulberg et al., there were fourteen (41 per cent)
class-II results, eighteen (53 per cent) class-III and IV results, and two
(6 per cent) class-V results. Although containment is the most widely
accepted principle of treatment for patients who have Legg-Perthes disease,
and the Atlanta Scottish Rite-type orthosis is the most commonly used
orthosis for this condition, there are few clinical data supporting the
effectiveness of this device. On the basis of our results, we do not
recommend the use of a weight-bearing abduction brace for the treatment of
severely involved hips.
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