A comparative study of ambulation-abduction bracing and varus derotation osteotomy in the treatment of severe Legg-Calvé-Perthes disease in children over 6 years of age.

Thirty-six patients with severe Legg-Calvé-Perthes disease were reviewed retrospectively to compare the results of ambulation-abduction bracing with varus derotation osteotomy. There were 17 brace patients and 19 osteotomy patients, and all were aged greater than 6.9 years. Treatment results were equal. The percentage of acetabular coverage, extent of lateral femoral subluxation, and the age of the patient affected outcome. The varus neck-shaft angle and leg length discrepancy resulting from the osteotomy were not permanent. The articular trochanteric distance appeared to be affected more by the neck-shaft angle recovery than by epiphysiodesis of the greater trochanter.