Combined innominate and femoral osteotomy for the treatment of severe Legg-Calvé-Perthes disease.

Nine patients who underwent combined innominate and femoral osteotomy for the treatment of Legg-Calvé-Perthes disease were evaluated. All had Catterall group III or IV involvement, the average number of radiographic "head-at-risk" signs was 3.2, and the average epiphyseal extrusion was 26%. At an average follow-up of 50.5 months, the clinical results were seven good and two fair. The radiographic results were four good, four fair, and one poor. We believe this procedure is indicated in the older patient with severe Perthes disease in whom femoral head subluxation or deformity makes containment difficult or impossible by more conventional methods.