In Legg-Calvé-Perthes disease, Herring lateral pillar classification is used to predict outcome. In which lateral pillar group does more than 50% lateral pillar height collapse predict a poor outcome with residual femoral head deformity at skeletal maturity?

• A Group A
• B Group B
• C Group B/C border
• D Group C ✓

Explanation

Herring lateral pillar classification (A, B, B/C border, C) uses the AP radiograph at the stage of maximal fragmentation. Group A has no lateral pillar involvement; Group B has >50% lateral pillar height maintained; Group C has <50% lateral pillar height (>50% collapse). Group C carries the worst prognosis — high risk of femoral head deformity (Catterall spherical deformity), early arthritis, and poor long-term outcome. Group B/C border cases are intermediate and may benefit from containment procedures (varus osteotomy/pelvic osteotomy) if age >8 years.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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