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Shelf Procedure
GuestPostJuly 6, 2012, 13:40
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Normal topicShelf Procedure

Hello again! My 9 year old son was diagnosed with Perthes in April of this year. We went straight into a program of physio and we were given crutches and a wheelchair. Two weeks ago we went for more x-rays and we were told that the head of the femur had collapsed and the Perthes had entered the re-modelling phase. This sounded a bit like 'do you want the good news or the bad'!! We were also told we were being transferred to a Paediatric Orthopaedic Consultant. We went to hospital again this week to meet the new consultant and we have been told that as the head of the femur is quite flattened they will probably want to do a 'Shelf Procedure' but that will be discussed when we go to the Perthes Clinic in August. I have so many questions that I want answers to now, not in August and would be very grateful if anyone can help. What is a 'Shelf Procedure'? Will there be a long recovery time? Will he be in a wheelchair after it? Do we need to have the operation? Will it actually help? I feel I need to be prepared for the discussion in August not blown away by the severity of it all. That way I stand a chance of having some relevant questions written down not thinking of them on the journey home! Many thanks 🙂

GuestPostJuly 13, 2012, 15:19
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Normal topicRe: Shelf Procedure

Hi

My son is nearly 9 and was diagnosed last October. He had a shelf procedure in January. We were told at the time that it may help but doesn't always. They basically took a piece of bone from his side and used it to create a curved shelf above where the hip bone would sit. The hope was that it would stabilise the hip and they are hoping it will help mould the femoral head back into the correct shape as it grows back. He was in hospital for around 4 or 5 days afterwards on traction. It was quite painful at first but they got him up walking on crutches on around day 4 and he became mobile very quickly. He was walking unaided by the end of the second week and after a 6 week check was allowed to resume normal activities. He initially had more movement in his hip, although this seems to have reduced and he is going to have physio. He gets less pain than he used to. His bone has mostly regrown but the femoral head is still flat so it is just a case of watching and waiting. You should be able to decide whether or not to have the operation. I hope this helps.

GuestPostAugust 29, 2012, 11:03
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Normal topicRe: Shelf Procedure

Hi Rebecca,

Many thanks for your reply which was very helpful. We had an appointment on the 24th with our new paediatric orthopaedic consultant, she has been highly reccommended to us and is extremely nice. She said if we were going to have the shelf procedure done it should have been done back in April just after diagnosis but as we have only just been transferred to her it is not really an option. However she says she would like to perform an xray called an Arthrogram. She says she needs him to be asleep while she performs this xray so we have not actually avioded him going to theatre. We have not yet told him the full extent of his next hospital visit as he is a worrier, we'll leave that til a couple of days before he goes in. I do not know how he will cope with this news and I can see some 'bribery' looming! How did your son cope with the knowledge he was going into hospital?

GuestPostAugust 29, 2012, 19:46
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Normal topicRe: Shelf Procedure

Hi Nancy my boy had the arthogram done in March on his 6th birthday! We explained it to him by saying he was going to have to go to sleep for a special X-ray because he has to stay very still. When he woke up he was in no pain and in fact had better movement because the specialist moved him into a better position whilst asleep. We were warned he could wake up in plaster but thankfully it was not needed. He had no ill effects and was up and about the next day as normal, the specialist came to see us in the recovery room to give us the results which was a massive help and saved us worrying. It all took about 90 minutes in total. All the best xxx

GuestPostNovember 26, 2013, 12:22
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Normal topicRe: Shelf Procedure

My 9 Year old son has been recommneded to have the shelf procedure on the 19th December although i'm unsure how necessary this is and what the recovery rates are like?

Can anyone offer any advice who has been through this at all as I'm really concerned about making this process the best and the least painful where possible. Help!!

GuestPostJune 3, 2015, 12:41
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Normal topicRe: Shelf Procedure

Hello. My son has just turned 7 and 6 weeks ago was diagnosed with PD. the MRI showed 75% femoral head involvement. His consultant suggested shelf procedure, which was done on 18 May. My son spent 2 nights in hospital and 2 weeks at home. He has just gone back to school. He can walk unaided but is still in pain. We're doing physio exercises at home. If there's anyone whose child had a shelf procedure done and would like to share their experiences I would be very grateful. Has this operation worked for your child? There's a lot of people telling about osteotomy, but it's difficult to find people whose children had shelf procedures. Please let me know if you've had any experience with shelf procedure. Thanks

lisaPostJune 3, 2015, 18:00
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September 7, 2011, 13:46
Normal topicRe: Shelf Procedure

Quote from Kaska on June 3, 2015, 12:41
Hello. My son has just turned 7 and 6 weeks ago was diagnosed with PD. the MRI showed 75% femoral head involvement. His consultant suggested shelf procedure, which was done on 18 May. My son spent 2 nights in hospital and 2 weeks at home. He has just gone back to school. He can walk unaided but is still in pain. We're doing physio exercises at home. If there's anyone whose child had a shelf procedure done and would like to share their experiences I would be very grateful. Has this operation worked for your child? There's a lot of people telling about osteotomy, but it's difficult to find people whose children had shelf procedures. Please let me know if you've had any experience with shelf procedure. Thanks

Hello Kaska

Osteotomy just means cutting the bone, so there are many types of osteotomy, in fact the shelf procedure used to be called a Salter's Osteotomy. The help procedure is very common and has a good success rate, it's very early days yet, is he using a walking frame or fully weight bearing?

lisaPostJune 3, 2015, 18:01
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September 7, 2011, 13:46
Normal topicRe: Shelf Procedure

shelf not help.. predictive text is a nuisance!

GuestPostJune 8, 2015, 12:17
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Normal topicRe: Shelf Procedure

Hello Lisa
Thank you very much for your reply. I actually should've said 'other osteotomy' because as you mentioned shelf procedure is also osteotomy. It was actually called shelf osteotomy on the operation consent form. The consultant explained that the type of shelf procedure that my son had was a Staheli one. My son, Felix was using a frame for the first 1-2 weeks. We were mainly at home during that time so there was no real walking, he was also crawling around the house! Two weeks after the operation he went back to school (I take him by car). I must say that although he complains about pain he still wants to do things e.g. go to play park after school and kind of runs about with other boys. His class went for a trip last Thursday and he wanted to go so much that I allowed him to go and he was on his feet for most of the day. I'm thinking that he is maybe overdoing his leg but it is just so difficult to stop him. The consultant said only: no running, jumping and sport, and let him walk as much as he feels it's ok for him, because he believes 'there needs to balance between how we manage the condition and patients quality of life'... I still don't really understand the disease, and it seems nobody fully understands it and it's difficult.

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