Legg Calve Perthes Disease
Legg Calve Perthes Disease is the name given to idiopathic osteonecrosis of the capital femoral epiphysis of the femoral head. Legg-Perthes disease, Perthes disease, coxa plana, aseptic or avascular necrosis of the femoral head. All of these names still amount to - a deterioration of the head of the femur due to insufficient blood supply. As a result of the insufficient blood supply the head of the femur begins to die and disintegrate. The disintegration can be seen, through x-rays as a flattening of the femoral tip.Most often, only one leg is affected. This condition occurs more frequently in males, between the ages of 4 to 10 years. Some family bloodlines tend to have extremely high incidence of this condition, while other bloodlines appear to be less susceptible. This is typically followed by revascularization over a period of 18 to 24 months. During the period of revascularization, the bone is soft and liable to fracture under pressure, causing collapse of the head of the femur. Over time, the head of the femur heals and remodels in the collapsed position, resulting in a nonspherical shape. This leads to stiffness and pain.The long-term outlook for Legg-Calve-Perthes disease is often good - especially for children who develop the condition very young. The younger the child, the more time there is to reshape the affected hip bone. We will look for a slight limp in your child's walk, a common sign of Perthes disease.We also will ask questions about any pain your child might be feeling. Then we will examine your child.
The doctor will gently move your child's legs, comparing the movement on the sore side with the movement on the other side. Legg-Calvé-Perthes disease goes through four phases of changes that affect the head of the femur. Portions of the bone turn into dead tissue. The ball of the thigh bone becomes less round in appearance on x-rays. This phase can last from several months up to one year. The body cleans up the dead bone cells and replaces them with new, healthier bone cells. The femoral head begins to remodel into a round shape again. The joint is still irritated and painful. This phase can last from one to three years The femoral head continues to model itself back into a round shape with new bone and Normal bone cells replace the new bone cells. This last phase can last a few years to complete the healing process.
Causes of Legg Calve Perthes Disease
Common causes of Legg Calve Perthes Disease
- The blood supply to the capital femoral epiphysis is interrupted.
- Changes to the epiphyseal growth plate occur secondary to the subchondral fracture.
- Revascularization occurs.
- Bone infarction occurs.
- Fracture of the neck.
- Injury or abnormal blood clotting.
Symptoms of Legg Calve Perthes Disease
Common symptoms of Legg Calve Perthes Disease
- Limping .
- Pain or stiffness in the hip.
- Groin or knee is possible as well.
- Shorter.
- Synovial lining of the joint.
- Wasting of muscles in the upper thigh.
- Difficulty walking.
Treatment of Legg Calve Perthes Disease
Common Treatment of Legg Calve Perthes Disease
- your child's tolerance for specific medications, procedures, or therapies
- Treatment of this condition will also vary dependent upon severity. In mild cases, enforced rest may be adequate. Resting can allow the body to generate new bone cells replacing the damaged ones. In more advanced cases surgery may be needed
- Crutches can ease pain by keeping the child's weight off his or her hip.
- Temporarily immobilizing the bone can help promote healing. This may be done with leg or hip casts, leg braces or traction.
- If a groin muscle has shortened due to excessive limping, it may be surgically released from the bone. After surgery, the affected leg is put in a cast for six to eight weeks to allow the muscle to grow to a more normal length. Sometimes the hip ball must be replaced within the socket. In other cases, the hip socket is repositioned.
- Over-the-counter medications such as ibuprofen can help relieve pain and reduce joint inflammation. These medications are often recommended for months at a time. The dosage may be decreased as the hip begins to heal.
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