The Results of Conservative Therapy

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The Results of Conservative Therapy for
Legg-Calve-Perthes Disease With Hip Abduction
Using Nishio's Non-weight Bearing Brace
Yutaka Oketani MD., Hideaki Kubota MD. PhD., Suin
Ryu MD., Aiji Matsuura MD. Ortho. Dep. In
Saga Handicapped Hospital, JAPAN Toshio Fujii
MD. PhD., Kazuyuki Takamura MD. PhD., Haruhisa
Yanagida MD., Akifusa Wada MD. PhD. Ortho. Dep.
In Fukuoka Childrens Hospital, JAPAN
(EPOS/IFPOS Combined Meeting, Sorrent, Italy,
11-14 April 2007)
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Purpose

• To report the results of the non-weight
  bearing hip abduction brace (Nishios Brace) for
  unilateral Legg-Calve-Perthes disease and to
  show the patients activity with Nishios Brace

Materials

• 1981-2004 (23 years)
• At Fukuoka Childrens Hospital, JAPAN
• 97 unilateral LCPD cases ( all 263 cases)
• observed from the first visit (without previous
  treatment)
• in necrosis period or division period

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Materials

• Male Female 85 12
• Right Left 46 51
• Mean age at first visit 6 y. 6 m. old
• Mean age at last follow-up 13 y. 1 m. old
• Mean follow up period 6 y. 7 m. old

Patients Evaluation

• Age (4 and less, 5 8, 9 and more)
• Catterall (group 1, 2, 3, 4)
• Lateral Pillar (A, B, B/C, C)
• Stulberg (class I, II, III, IV, V)

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Results
Lateral Pillar
Catterall
Type1 2
Group A 8
Group C 13
Type4 19
Type2 37
Group B/C 22
Type3 39
Class V 2
Group B 54
Class IV 9
Class I 26
Class III 20
Stulberg I,II
100 68
Total
Class II 40
Stulberg
5
Sex - Stulberg
Age - Stulberg
Lateral Pillar-Stulberg
Catterall-Stulberg
6
Other Results in JAPAN
Our DATA
Unilateral
33
68
Brace
Modified A-cast
Bilateral
33
97
Brace
Atlanta type
Batchelor type
()
Stulberg I,II
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Case1
4 years later
At first visit
8 months later
17 months later
8years 4months Male(H,Y)
Remove brace
Stulberg II
Catteral III
Lateral Pillar B
9
Case2
31 months later
11 years later
At first visit
19 months later
4 years 5 months male (T.Y)
Remove brace
Stulberg II
Catteral IV
Lateral Pillar B/C
10
Summary

• Nishios Brace treatment showed good results
  rather than other unilateral type brace in JAPAN.
• Bilateral type brace has also better results with
  a lot of limitation in daily life.
• We recommend Nishios brace because of its good
  results and less restriction on ADL in
  comparison with the others.