In Perthes disease, the Herring lateral pillar classification is used to guide prognosis and treatment. What does lateral pillar group C indicate?

• A Lateral pillar maintained >50% of its original height
• B No involvement of the lateral third of the femoral head (lateral pillar normal)
• C Lateral pillar completely collapsed with <50% of original height, associated with poor prognosis ✓
• D Total head involvement (pan-head necrosis) in children under 8 years

Explanation

The Herring lateral pillar classification assesses the height of the outer third (lateral pillar) of the epiphysis at the fragmentation stage: Group A = lateral pillar maintains >50% height (good prognosis, no containment needed); Group B = maintains >50% but with some involvement; Group C = lateral pillar maintains <50% of original height with significant collapse. Group C carries the worst prognosis for femoral head deformity (coxa magna/plana) and requires active containment treatment (osteotomy or orthosis) in older children.

Reference: Maheshwari Essential Orthopaedics, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.