Legg-Calve Perthes Disease

What?

*Temporary condition where the ball shape part of the thigh bone, femoral head, loses its blood supply

*Occurs on one side and rarely occurs on both

*Idiopathic, the cause is unknown

*Two year process

Who?

Most commonly seen in boys from 4 to 8 years of age

Affects those between 2 and 18 years of age

Signs and Symptoms?

Limp

Pain

Stiffness

Limited range of Motion

 

How is it Diagnosised?

Examination

X-ray

MRI

How is Perthes Treated?

*Patient is non weight bearing on the affected side for up to two years using either wheelchair or crutches

* Surgery

* A-frame cast

* Bracing

* Range of Motion Exercises

* Activity Restrictions

Goals of Treatment:

*treat as early as possible

*allow as much time as possible to let the femoral head remodel back into a round shape

* maintain hip motion

*control pain

Surgery

            Non weight bearing on affected side

          Exam under Anesthesia, Adductor Tenotomy, and Placement of

          A-Frame Cast

          Possible Measure of Brace

Cast is on for 4 to 6 weeks

            Patient is unable to shower during this time period. Sponge baths are recommended.

 

Brace

            Patient is placed in a brace when cast is removed for 20 out of 24 hours of the day in the beginning

          Patient is weaned out of brace per physician

Hip Abduction Pillow

The patient is x-rayed throughout the growing process to monitor bilateral leg lengths.

 

The most critical factors that determine the outcome are the child’s age and how the femoral head is affected by this condition.

 

The more severe the case, the greater the likelihood that the child may experience limited range of motion, differences in leg lengths and further hip problems in adulthood.

 

It is important to keep an optimistic outlook for the child because this is a long process.

Wheelchair Options Depending on Insurance:

Chunc chair

Reclining Wheelchair

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