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Greater trochanter apophysiodesis in Legg–Calve–Perthes disease: Which implant to choose?

1 Baltalimani Bone Diseases Education and Training Hospital, Department of Pediatric Orthopaedic Surgery, Istanbul, Turkey
2 Sultanbeyli State Hospital, Istanbul, Turkey

Correspondence Address:
Evren Akpinar,
Metin Sabanci Baltalimani Bone Diseases Education and Training Hospital, Department of Pediatric Orthopaedic Surgery, Rumeli Hisari St. No: 62 34470 Sariyer, Istanbul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ortho.IJOrtho_166_18

Background: Greater trochanter apophysiodesis (GTA) is relatively minimal invasive technique for the treatment of trochanteric overgrowth. Various types of implants can be used in each procedure. The purpose of this study was to compare outcomes of three different types of implants that were used in treatment of trochanteric overgrowth in Legg–Calve–Perthes disease. Materials and Methods: We retrospectively studied radiological results of three implants (screw, screw washer, and EP) on inhibiting trochanteric growth in 32 patients. Articulo-trochanteric and trochanter-trochanter distances (TTDs) were measured on radiographs. Embedding of implant evaluated on final radiographs. Results: The mean of age at the surgery was 10 ± 2.3 years, and the mean of follow up period was 50.0 ± 16.7 months. In all groups, articulo-trochanteric distance was decreased on final radiographs. In screw and screw washer group, increase of TTD was not statistically significant (P < 0.05). Twelve, one, and two implants were embedded, respectively, in screw, screw washer, and EP groups. Two patients in EP group had revision surgery due to loosening. Conclusions: In this study group, GTA using screw and screw washer methods could slow down but did not restore trochanteric overgrowth. We suggest using washer to reduce embedding of the screw.

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