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    The accuracy and reliability of estimation of lateral pillar height in determining the herring grade in Legg-Calve-Perthes disease
    (Lippincott Williams & Wilkins, 2004) Akgun, R; Yazici, M; Aksoy, MC; Cil, A; Alpaslan, AM; Tumer, Y
    The amount of the preserved lateral pillar height (LPH) for assigning Herring grades is estimated during daily practice in Perthes disease. Despite this estimation, Herring classification has been reported to have a good interobserver agreement. The purpose of this study was to investigate whether the amount of preserved LPH has an effect on interobserver agreement. The results of surgeons' estimates were compared with objective measurement results. Good agreement was found among three experienced pediatric orthopaedic surgeons in 50 patients (1 vs. 2, kappa = 0.527; 2 vs. 3, kappa = 0.526; 1 vs. 3, kappa = 0.539). Twenty of these cases had a ratio of the LPH scattered between 0.45 and 0.60 and 0.90 and 0.99 (transition between group B and C, and group A and B). When the borderline cases were evaluated separately, the interobserver reliability was poor (1 vs. 2, kappa = 0.194; 2 vs. 3, kappa = 0.256; 1 vs. 3, kappa = 0.154), which may be explained by misperception of the preserved LPH. If the Herring classification is to be used as the prognostic indicator for deciding among the treatment alternatives, and LPH is the major determinant of the management, measurements should be used instead of estimates, especially in borderline cases.
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    Occult spinal dysraphism and its association with hip dysplasia in females
    (Springer-Verlag, 2003) Ucar, DH; Ömeroglu, H; Eren, A; Inan, M; Baktir, A; Aksoy, MC; Ömeroglu, S
    We examined the pelvic radiographs of two groups of patients (more than 12 years of age) from six medical centres. Hip dysplasia was considered to be present if Shenton's line was broken and more than one third of the femoral head was revealed to be uncovered in an antero-posterior radiograph of the pelvis. Patients with hip dysplasia due to teratological or neurological causes were excluded. There were 291 patients with treated or untreated hip dysplasia in the dysplastic group. The control group of 415 individuals was collected from consecutive outpatients (with a pre-set standardised female/male ratio) for whom an antero-posterior radiograph of the pelvis had been made in one of two medical centres and which did not disclose any abnormality of the hip joints. The aim of the study was to assess the coexistence of hip dysplasia and occult spinal dysraphism. Radiographs of all patients were examined, and any partial or complete defect of the posterior vertebral arch was recorded. In the dysplastic group, a defect was recorded in 23% (67/291) radiographs and in the control group in 12% (48/415). In both groups, L5 and S1 were the most commonly recorded sites with a defect. In the dysplastic group, a defect was recorded in 56/190 females and in the control group in 30/302 females. In males, there was no significant difference between the recorded findings in the two groups. In females with hip dysplasia, occult spinal dysraphism seems to be fairly common.