Lateral shelf acetabuloplasty: an operation for older children with Perthes' disease.

Although 59% of children with Perthes' disease have a good result without treatment, poor results are common when the disease has onset in older children. Femoral osteotomy at this age will control the disease but may leave shortening and a persisting limp if there is insufficient capacity for remodeling and growth. Twenty children aged greater than 8 years with early disease were treated by lateral shelf acetabuloplasty. The results are compared with those in 14 children for whom no treatment had been advised. Lateral shelf acetabuloplasty has improved early outcome for these children as compared with untreated children for whom a poor prognosis has been confirmed.