In Legg-Calvé-Perthes (LCP) disease, the Herring lateral pillar classification determines prognosis. Group C (lateral pillar collapse >50%) is managed by:
- A Observation and NSAID analgesia
- B Surgical containment (Salter innominate osteotomy or varus proximal femoral osteotomy) ✓
- C Hip abduction orthosis to contain the femoral head within the acetabulum
- D Core decompression of the femoral head
Explanation
Herring lateral pillar Group C (>50% lateral pillar collapse) in children >8 years carries the worst prognosis for femoral head deformity. Surgical containment — either by acetabular reorientation (Salter/triple innominate osteotomy) or proximal femoral varus derotation osteotomy — positions the necrotic femoral head within the acetabular mould to prevent flattening (coxa plana) during revascularisation. Conservative containment with abduction splints is less effective in older children with Group C disease. Core decompression is used for early avascular necrosis in adults, not LCP.
Reference: Maheshwari Essential Orthopaedics, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.