ĐÁNH GIÁ KẾT QUẢ PHẪU THUẬT HOẠI TỬ CHỎM XƯƠNG ĐÙI Ở TRẺ EM TẠI BỆNH VIỆN CHẤN THƯƠNG CHỈNH HÌNH THÀNH PHỐ HỒ CHÍ MINH

Abstract

Background: Surgical treatment for Perthes’ disease in children has been performed in Vietnam for many years, yielding promising clinical outcomes. However, the number of studies evaluating long-term outcomes to assess the efficacy and complications of this surgical approach remains limited. Objective: To evaluate the effectiveness of surgical treatment for Perthes’ disease at the Hospital for Traumatology and Orthopaedics. Methods: A retrospective descriptive study was conducted on a series of 33 pediatric patients who underwent surgery for Perthes’ disease at the Pediatric Department of the Hospital for Traumatology and Orthopaedics, with a postoperative follow-up period of ≥ 24 months. Preoperative classification was based on the Herring classification, while outcomes were assessed using the Harris hip functional score and the Stulberg classification of femoral head morphology. Results: Most patients who underwent surgery were older than six years (90.4%), with severe Herring grades (B/C accounting for 42.9% and C for 45.1%). The average follow-up duration was 6.1 years (range: 4–8 years). According to the Stulberg classification, type IV and V outcomes accounted for 38.9%. Among patients with Herring grade C lesions, surgical intervention during the fragmentation stage resulted in Stulberg type IV and V outcomes in 73% (8/11) of cases, while surgery during the reossification stage resulted in type IV and V outcomes in 66.7% (2/3) of cases. Regarding functional outcomes assessed by the Harris score, 90.6% of patients achieved a "very good" rating, and 9.4% achieved a "good" rating. Conclusion: Surgical intervention demonstrated positive results in improving hip joint function. However, three cases of limping were noted due to leg length discrepancies of ≥ 2 cm. Surgical outcomes were less favorable in children older than eight years with Herring grade C lesions.