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ABSTRACT OBJECTIVE: To present the preliminary results from treating patients with Legg-Calvé-Perthes Disease (LCPD) by means of hip arthrodiastasis using a monolateral external fixator applied to the hip and to succinctly describe the surgical technique used, in a prospective study. METHODS: Prospective study on 18 patients with LCPD who underwent surgical treatment by means of the hip arthrodiastasis technique using a monolateral external fixator. There were 13 male and five female patients of mean age 8.5 years, ranging from five to 13 years. All the patients presented unilateral hip impairment: nine on the right side and nine on the left. The results were evaluated at maturity using clinical and radiological criteria. RESULTS: All the patients evolved with improvement of joint mobility, and pain relief was achieved in 88.9% of them. Reossification of the femoral epiphysis occurred within the first three months of the treatment. The hips operated at the necrosis stage of the disease did not passed through the fragmentation stage, thus shortening the evolution of the disease. The results were 77.8% satisfactory and 22.2% unsatisfactory. CONCLUSION: Hip arthrodiastasis with a monolateral external fixator during the active phase of LCPD improved the degree of joint mobility. Use of the arthrodiastasis technique at the necrosis stage or at the fragmentation stage (active phase of the disease) presented satisfactory results from treatment of LCPD.

OBJETIVO: Apresentar os resultados preliminares da utilização da artrodiastase do quadril em pacientes portadores de artrite reumatoide juvenil e com comprometimento da articulação coxofemoral. MÉTODOS: Estudo prospectivo de 12 pacientes (seis meninos e seis meninas) com idades entre oito e 18 anos (média de 10,5 anos). Foi utilizado um fixador externo monolateral que permite os movimentos de flexão e de extensão no quadril. O fixador externo foi mantido por um período que variou de 78 a 90 dias, com média de 86 dias. O controle radiográfico foi realizado durante o ato operatório e, semanalmente, durante o período de tração e a cada quatro semanas, quando terminado este período. Na avaliação clínica dos resultados, incluímos a graduação da dor e o grau de movimentação articular, com medidas e avaliações pré e pós-operatórias. O período de acompanhamento variou de 12 a 15 anos, com média de 13 anos. RESULTADOS: O valor médio da escala de dor foi de nove (9) antes da operação e de quatro (4) no período pós-operatório. Em dois pacientes não ocorreu melhora da dor. O arco de movimento do quadril aumentou em todos os pacientes, com exceção de dois. Na avaliação radiográfica evidenciamos um aumento no espaço articular de 2mm, em média, e que se manteve no pós-operatório. Não foram observadas complicações com a utilização da técnica. Apenas verificamos soltura dos pinos de Schanz da região do osso ilíaco em dois pacientes. A técnica operatória não ocasionou resultado satisfatório. CONCLUSÃO: O procedimento de artrodiastase está bem indicado para a recuperação da mobilidade em uma articulação coxofemoral comprometida e rígida, como ocorre em pacientes com artrite reumatoide juvenil.OBJECTIVE: To present the preliminary results of the use of hip arthrodiastasis in patients with juvenile rheumatoid arthritis and involvement of the hip joint. METHODS: A prospective study of 12 patients (six boys and six girls) aged between eight and 18 years (mean 10.5 years). We used a monolateral external fixator that allows flexion and extension at the hip. The external fixator was maintained for a period ranging from 78 to 90 days, with a mean of 86 days. Radiographic control was performed during surgery, weekly during the traction period, and every four weeks once this period was completed. The clinical evaluation of results included the degree of the pain and the degree of joint movement, measured and evaluatedpre-and post-operatively. The follow-up period ranged from 12 to 15 years, with a mean of 13 years. RESULTS: The average pain score was nine (9) before surgery and four (4) in the postoperative period. There was no improvement in pain in two patients. The range of motion of the hip increased in all patients except two. Radiographic evaluation evidenced a2 mm increase in joint space, on average,that has remained postoperatively. There were no complications with this technique. Only a loosening of the Schanz screws in the region of the iliac bone was observed in two patients. The surgical technique did not bring satisfactory results. CONCLUSION: The arthrodiastasis procedure is well suited for recovery of mobility in animpairedand rigid hip joint, as occurs in patients with juvenile rheumatoid arthritis.