Shelf operation

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My son used to complain about having a sore leg normally at bed time which we put down to growing pains it wasn't until he developed a limp that we took him straight to the doctor who sent him to the hospital for x-rays.

He had x-rays and blood samples taken which all came back normal, we ended up with an arrogant doctor who said he must have hurt his leg some how and now he was limping from habit but to bring him back in a month for more x-rays, those never showed up anything either and we were sent home again.

A few weeks later he was still complaining of a sore leg so we went back to the hospital again they tried to fob us off put we persisted so he was sent for another x-ray, when we got back to the room there was 2 doctors in the room and I am happy to say the 2nd doctor noticed a problem with his hip movements right away and referred him to the children's hospital.

He was given an x-ray at Yorkhill which showed a difference in the hip joint and we were told he will need a shelf procedure and explained briefly what is involved.

We have searched the Internet trying to find out information on the operation but all we seem to find is medical jargon so any information on this Shelf procedure would be much appreciated.

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  • Posted

    Please ensure that you get a second opinion before allowing your child to have the operation. My son who was 6 had Perthes diease in both hips and was under the hospital until he was 13 years old. He had traction and a lot of bed rest in the early stages and no football or running around which is hard at that age.

    However we were lucky that we had a brilliant consultant who knew what he was talking about, one of his registrars wanted to operate on our son and we said that we wanted a second opinion from the consultant who advised us that he did not need to have the operation, if we had gone through with the registrar my son would have gone through with the operation which he did not necessairly need. It is hard going but go with your gut instinct. By the way my son is now 20 years old and plays football and everything physical :D .

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  • Posted

    From my research the Shelf procedure isn't popular anymore. But obviously there are going to be situations where its required. But in generally it seems they are not doing it for Perthes. A Endoscopic Pelvic Osteotomy has been suggested for our child. In some places like the US they seem to prefer an external fixator. But I don't think theres enough information on long term results for any of these procedures. Also everyone hip isn't the same. So whats rwrong for someone else might be right for you.

    http://www.jaaos.org/cgi/content/abstract/9/3/150

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  • Posted

    PiperP I don't know how you went about your research, but the internet is full of sites that state opinion rather than fact. The Shelf Procedure always has been and still is used for those children who have poor containment or a misshapen head of femur that will not benefit from a femoral osteotomy. The fixator is still experimental and carries a much higher risk of infection and again is not suitable for every child, whilst the vast majority of children need no treatment at all.

    Perthes disease has been a recognised condition for 100 years, but it is still the most confusing and poorly understood condition in paediatric orthopaedics.

    www.perthes.org.uk

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  • Posted

    Hi. My son has had perthes in both hips. When he was 7 he had a femoral osteotomy which was quite successful i think. He was left with some shortening if his leg and a bit if a swagger. He had to have the plaster cast on for 8 weeks which was fun!!!!

    When he was 13 he got it again in his other hip. This time he was too old for the femoral osteotomy so he had a shelf osteotomy. The prognosis isn't as good i dont think. The aim of the op is to improve the containment of the hip ball as it goes through the inevitable disease process. It is an attempt to maintain the roundness and integrity of the joint. Time will tell. He has been advised to refrain from impact sports for at least a year....not easy for a teenage boy.

    Its a cruel disease. We are fortunate that we live in liverpool and have had a good and honest surgeon.

    Hope this helps.

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  • Posted

    I hope that you son is doing fine. My son will be 7 tomorrow. 2 weeks ago he was dignosed with Perthes. He had Xray and MRI, We saw a consultant yesterday who told us that my son's head involvement is 75% and he reccommended shelf procedure. I had not heard about this procedure before, and although it sounds logical to me I'm just wondering why it is not so popular and why one cannot find as much about it as about osteotomy. Please let me know if you child had this operation, how it was for him and whether you think it was successful. I will appreciate any information.
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