داء بيرثيس في مرحلة التفتت المتأخرة (المرحلة IIb) أو إعادة التشكل — عندما لم يحلّ بضع العظم بالقلس الإبعادَ المفصلي

References

1. Treatment in the late part of the stage of fragmentation or in the early part of the stage of reconstitution attempts to minimize the effects of early deformation of the femoral head that has already occurred.
2. At this stage, some children have a reduced range of motion (particularly abduction) and attempted abduction results in hinging.
3. A valgus osteotomy will increase uncovering of the femoral head, and this can be addressed with a shelf procedure.
4. However, the shelf procedure should be delayed in the younger child as the acetabular cover may improve spontaneously once the abnormal forces on the lateral rim of the acetabulum while hinging are relieved by the valgus osteotomy.

DOI: 10.4103/0019-5413.143906