[Conservative containment in the treatment of Legg-Calvé-Perthes disease]. / Konzervativni containment pri lécení Legg-Calvé-Perthesovy choroby.

The article presents results of the conservative containment treatment by means of abduction splint the Scottish Rite Hospital--Atlanta: achieved in the group of 21 children three to eight years old. The mean duration of the observation is 27 month (12 to 48 month). In 13 cases (62 per cent) the treatment was done merely by the application of the abduction splint, in 9 cases the application of the splint represented a preparatory phase for the surgical treatment according to the principles of containment. For the main objective of the treatment the authors consider the necessity of the preservation of the spherical shape of the head or remodellation of the head already deformed into the original shape. They test the course and successfulness of the treatment by means of arthrography or magnetic resonance. For the determination of further treatment the contribution of these examinations is comparable. Magnetic resonance is moreover able to determine an exact range of the affection of the head including also minimum changes in the contralateral joint.

[Initial experience with the Steel triple osteotomy in the treatment of arthrosis of the hip joint as a result of congenital hip dysplasia]. / První zkusenosti s trojí osteotomií pánve podle Steela pri lécení artrózy kycelního kloubu jako následku vrozené dysplazie kycelní.

The age of the patients was 18 to 40 years (mean age 32 years), the interval after operation was 5 months to 3 years (mean 17 months). In all 8 patients proper covering of the head was achieved, CE angle 25-45 degrees, mean gain of CE angle 35 degrees. The X-ray picture revealed widening of the articular space and reabsorption of arthritic pseudocysts. As regards the clinical picture, marked regression of complaints was recorded. Osteotomy of the pelvis according to Steele prolongs the vitality of the hip joint: a) by increasing the contact surface in the hip joint, b) by shifting the till then minimally burdened and thus minimally usurated cartilage into the zone of the main burdening, c) the usurated cartilage, on the other hand, is shifted beyond this zone. Moreover, osteotomy of the pelvis prepares a bed for anchoring of the cup of a possible future prosthesis. The above facts are advantages, as compared with different types of osteotomies of the femur, which moreover may in future cause further complications of the implantation of the femoral component of the artificial joint.