Materiały źródłowe

• #1 Legg-Calve-Perthes Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease (also known as Perthes disease) is a rare condition in which the ball-shaped head of the thighbone (femoral head) temporarily loses its blood supply. As a result, the head of the thighbone collapses, and the area becomes inflamed and irritated. […] Your child’s treatment will depend on their age, range of motion in their hip, and extent of the condition. Your child’s orthopedic specialist will recommend a treatment based on the degree of your child’s hip pain, stiffness, and how much of the head of the thighbone has collapsed. […] Non-surgical approaches to treatment may include: Activity restrictions, Anti-inflammatory medication, Bed rest and traction, Casting or bracing to: Hold the head of the thighbone in the hip socket, Permit limited joint movement, Allow the thighbone to remold itself into a round shape, Physical therapy, to keep the hip muscles strong and promote hip movement.

• #2

  https://www.shrinerschildrens.org/en/pediatric-care/legg-calve-perthes

  Legg-Calv-Perthes disease, or Perthes disease, is a childhood bone disorder that typically only affects one hip, although roughly 10% of children experience it in both hips. […] Symptoms tend to appear between the ages of 4 and 8, and boys are four times more likely to get Perthes disease. […] Legg-Calv-Perthes disease is caused by disrupted blood flow to the femoral head of the thigh bone. This may result in necrosis and collapse of the bone in the femoral head. New bone eventually replaces the old, but the previous rounded shape of the bone may now be abnormal. […] When blood stops flowing to the femoral head, it begins breaking down and losing its round shape, making it difficult to fit and move in the hip socket as it should. This impacts mobility, causes pain, and can lead to early-onset osteoarthritis.

• #3

  https://www.shrinerschildrens.org/en/pediatric-care/legg-calve-perthes

  Legg-Calv-Perthes disease, or Perthes disease, is a childhood bone disorder that typically only affects one hip, although roughly 10% of children experience it in both hips. […] Symptoms tend to appear between the ages of 4 and 8, and boys are four times more likely to get Perthes disease. […] Legg-Calv-Perthes disease is caused by disrupted blood flow to the femoral head of the thigh bone. This may result in necrosis and collapse of the bone in the femoral head. New bone eventually replaces the old, but the previous rounded shape of the bone may now be abnormal. […] When blood stops flowing to the femoral head, it begins breaking down and losing its round shape, making it difficult to fit and move in the hip socket as it should. This impacts mobility, causes pain, and can lead to early-onset osteoarthritis.

• #4 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  Legg-Calve-Perthes disease (LCPD) is idiopathic osteonecrosis or idiopathic avascular necrosis of the capital femoral epiphysis of the femoral head. This activity presents the clinical presentation, evaluation, and management of Legg-Calve-Perthes disease and highlights the role of the interprofessional team in the management of affected patients. […] Explain the importance of improving care coordination among interprofessional team members to improve outcomes for patients affected by Legg-Calve-Perthes disease. […] Goals of treatment include pain and symptom management, restoration of hip range of motion, and containment of the femoral head in the acetabulum. […] Nonoperative Treatment […] Activity restriction and protective weight-bearing are recommended until ossification is complete.

• #5 Legg-Calve-Perthes Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/826935-overview

  Legg-Calv-Perthes disease (LCPD) is avascular necrosis (AVN) of the proximal femoral head resulting from compromise of the tenuous blood supply to this area. LCPD usually occurs in children aged 4-10 years. The earliest sign of is an intermittent limp (abductor lurch), especially after exertion, with mild or intermittent pain in the anterior part of the thigh. Hip pain may develop and is a result of necrosis of the involved bone. Pain may be present with passive range of motion (ROM) and limited hip movement, especially internal rotation and abduction. Children with LCPD can have a Trendelenburg gait resulting from pain in the gluteus medius. […] Initial therapy includes minimal weightbearing and protection of the joint. Results of surgical containment appear to be better than those of nonsurgical containment (orthosis). Surgical management typically involves either femoral osteotomy to redirect the involved portion within the acetabulum or innominate osteotomy.

• #6 Musculoskeletal Disorders – Legg-Calve Perthes and Clubfoot

  https://leveluprn.com/blogs/pediatric-nursing/43-musculoskeletal-disorders-legg-calve-perthes-clubfoot?srsltid=AfmBOopaGclUE7KPJBOsip3prV92BaG2yH840KV485IBROKw0M2eSzHN

  Legg-Calve-Perthes is a disorder where a disruption of blood flow to the femoral head at the top of the thigh leads to necrosis or tissue death. […] Signs and symptoms of Legg-Calve-Perthes includes a painless limp, hip pain and stiffness that increases with activity, and reduced range of motion of the hip. […] Nonsurgical treatment of this disorder includes activity restriction with limited weight-bearing, as well as anti-inflammatory medications such as NSAIDs and physical therapy. If nonsurgical treatment is insufficient, then an osteotomy may be required. This is a surgery where the femur is cut, repositioned, and secured in the hip socket using plates and screws.

• #7 Legg-Calvé-Perthes Disease – Seattle Children’s

  https://www.seattlechildrens.org/conditions/legg-calve-perthes-disease/

  Children with Perthes disease often have a slight limp. In the early stages, they typically have a limp without any hip pain or soreness. Other symptoms include: […] The goals of nonsurgical treatment are to decrease symptoms as your child’s hip goes through the healing process and to prevent future hip problems. […] Early in the healing process, it may be best to reduce your child’s activity and keep them from sports that are rough or may involve high impact on their hip. […] We may recommend using a brace to help maintain or improve range of motion in your child’s hip or using crutches (or a wheelchair for long distances) to take weight off their leg. […] Physical therapy may also help with pain and range of motion. […] To reduce pain, doctors may recommend acetaminophen. In some cases, vitamin D and other medicines may improve bone healing.

• #8 Legg-Calve-Perthes disease – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/care-at-mayo-clinic/mac-20374355

  At Mayo Clinic, orthopedic surgeons work with radiologists, physical therapists and other specialists to evaluate and treat people with Legg-Calve-Perthes disease. This means that you’re getting more than just one opinion you benefit from the knowledge and experience of each specialist on the multidisciplinary team. […] Perfusion MRI is an option at Mayo Clinic. This advanced form of MRI can show how much blood is getting to the femoral head, which helps in choosing appropriate treatments for children with Legg-Calve-Perthes disease. The latest surgical techniques are available, as are physical therapists who specialize in the care of children. […] Pediatric orthopedic surgeons collaborate closely with adult hip surgeons to provide the full complement of care for adolescents with Legg-Calve-Perthes disease.

• #9 Legg-Calve-Perthes Disease: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/legg-calve-perthes-disease-maxs-story

  When Max, an active, sports-obsessed 7-year-old, experienced leg pain, it seemed like a simple pulled muscle. […] The pediatrician suspected Legg-Calve-Perthes disease, a rare disorder that deforms the femur, causing significant pain and lost flexibility at the hip. […] Their first consultation at CHOP confirmed the diagnosis of Legg-Calve Perthes disease. […] Max spent six weeks in an A-frame cast to ensure proper positioning while his hip joint healed. […] The local orthopedist warned the family that Max might not be able to run or jump for three years during his treatment and healing. […] The goal of treatment was to contain the femoral head while it regrew and help it retain its round shape to fit into the hip socket properly. […] Max had physical therapy once or twice a week and got X-rays every three months to monitor the healing progress in his femur and hip joint.

• #10 Legg Calve Perthes Disease (LCP) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease, often called Perthes disease, is an uncommon condition in children affecting the hip. […] The main focus in treating Legg-Calve-Perthes disease is to maintain as much bone in the femoral head and keep it as round as possible. The younger the child and the least amount of bone damage provide the child with the best outcome in keeping a healthy hip joint and avoiding pain, stiffness and arthritis. It is important for children and parents to follow the instructions regarding activities and exercise provided by the specialists. […] In more severe cases, some children require surgery to improve the hip joint movement and help reduce pain. If your child should require surgery, the doctor will discuss the type of surgery, recovery time, and expected results from the surgery.

• #11 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  Perthes disease is a rare childhood condition that affects the hip. It occurs when the blood supply to the rounded head of the femur (thighbone) is temporarily disrupted. Without an adequate blood supply, the bone cells die, a process called avascular necrosis. […] Treatment for Perthes focuses on helping the bone grow back into a more rounded shape that still fits into the cup-shaped acetabulum (the socket of the hip joint). This will help the hip joint move normally and prevent hip problems in adulthood. […] The goal of treatment is to relieve painful symptoms, protect the shape of the femoral head, and restore normal hip movement. If left untreated, the femoral head can deform and not fit well within the acetabulum (hip socket), which can lead to further hip problems in adulthood, such as early onset of arthritis.

• #12 Legg-Calvé-Perthes disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/legg-calve-perthes-disease

  Specific treatment for Legg-Calv-Perthes disease will be determined by your child’s doctor based on: […] The goal of treatment is to preserve the roundness of the femoral head and to prevent deformity while the condition runs its course. Treatment options are dependent on the amount of hip pain, stiffness, and X-ray changes over time, as well as how much of the femoral head has collapsed. […] Although there is some controversy about the pros and cons of various treatment options, the principles of treatment in Perthes are the same. The first goal is to regain hip motion and keep the ball as round as possible in order to maximize the function of the hip into adulthood. […] Containment is another major guiding principle in the treatment of Perthes disease. Containment refers to the concept of keeping the soft ball (femoral head) deep within the socket (acetabulum) so that the socket itself acts as a mold to keep the ball round.

• #13 Legg Calve Perthes Disease

  https://www.massgeneral.org/orthopaedics/children/conditions-and-treatments/legg-calve-perthes-disease

  Legg Calv Perthes disease is a condition characterized by a temporary loss of blood supply to the femoral head (top of the femur). […] The overall goal of treatment is to: Reduce hip irritability and pain, Restore and maintain hip mobility, Prevent the femoral head from extruding or collapsing, Regain a spherical shape of the femoral head. […] Once the diagnosis is confirmed (usually via x-rays), a decision is made as the whether any active treatment is needed. […] The goal of treatment today is to preserve the roundness of the femoral head and to prevent deformity while the condition runs its course. […] Instead, the contemporary concept in treating Perthes disease is containment of the femoral head in the acetabulum (socket). […] All treatment options (non-surgical and surgical) for Perthes disease try to position and hold the femoral head in the acetabulum as much as possible.

• #14 Legg-Calve-Perthes Disease | Texas Children’s

  https://www.texaschildrens.org/content/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease is treated by keeping the thighbone as round as possible and inside the socket. This is called containment. It lets the bone heal and makes sure the hip keeps good range of motion. […] Treatment may include: Bed rest, Limiting certain activities, like running, Physical therapy, Anti-inflammatory medicine to help with pain and stiffness in the hip, A cast or brace, Use of walker or crutches. […] If these methods do not work, surgery may be needed. The type of surgery depends on how bad the problem is and the shape of the ball in the hip joint. It may range from a procedure to make a groin muscle longer to osteotomy, a major surgery to reshape the pelvis. […] Early diagnosis and regular follow-up visits with an orthopedic specialist are important.

• #15 Legg-Calvé-Perthes disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/legg-calve-perthes-disease

  Specific treatment for Legg-Calv-Perthes disease will be determined by your child’s doctor based on: […] The goal of treatment is to preserve the roundness of the femoral head and to prevent deformity while the condition runs its course. Treatment options are dependent on the amount of hip pain, stiffness, and X-ray changes over time, as well as how much of the femoral head has collapsed. […] Although there is some controversy about the pros and cons of various treatment options, the principles of treatment in Perthes are the same. The first goal is to regain hip motion and keep the ball as round as possible in order to maximize the function of the hip into adulthood. […] Containment is another major guiding principle in the treatment of Perthes disease. Containment refers to the concept of keeping the soft ball (femoral head) deep within the socket (acetabulum) so that the socket itself acts as a mold to keep the ball round.

• #16 Legg-Calve-Perthes Disease | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/legg-calve-perthes-disease

  Legg-Calve-Perthes disease is a childhood femoral head ischemia of unknown etiology that may lead to permanent hip deformity. […] Treatment is aimed at maintaining a spherical femoral head within a reduced and concentric joint. […] The most common treatment is containment which can be achieved non-operatively through casting and bracing or operatively through femoral or pelvic osteotomy. […] The main goal in LCPD treatment is to achieve a spherical femoral head and concentric joint at the conclusion of the disease process, thereby remaining within Stulberg class I and II. […] Standard treatment options include symptomatic treatment and containment treatment. […] Symptomatic treatment typically includes activity modifications, protected weightbearing, and physical therapy focused on maintaining hip range of motion, specifically abduction.

• #17 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  There are many treatment options for Perthes disease. Your doctor will consider several factors when developing a treatment plan for your child, including: Your child’s age. Younger children (age 6 and below) have a greater potential for developing a round femoral head after healing. […] Nonsurgical Treatment: Observation. For very young children (2 to 6 years old) who show few changes in the femoral head on their initial X-rays, the recommended treatment is usually simple observation. Your child’s doctor will regularly monitor your child using X-rays to make sure the regrowth of the femoral head is on track as the disease runs its course. […] Anti-inflammatory medications. Painful symptoms are caused by inflammation of the hip joint. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are used to reduce inflammation, and your child’s doctor may recommend them for several months.

• #18 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  There are many treatment options for Perthes disease. Your doctor will consider several factors when developing a treatment plan for your child, including: Your child’s age. Younger children (age 6 and below) have a greater potential for developing a round femoral head after healing. […] Nonsurgical Treatment: Observation. For very young children (2 to 6 years old) who show few changes in the femoral head on their initial X-rays, the recommended treatment is usually simple observation. Your child’s doctor will regularly monitor your child using X-rays to make sure the regrowth of the femoral head is on track as the disease runs its course. […] Anti-inflammatory medications. Painful symptoms are caused by inflammation of the hip joint. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are used to reduce inflammation, and your child’s doctor may recommend them for several months.

• #19 Symptoms, Causes and Treatment of Perthes Disease | HSS

  https://www.hss.edu/conditions_legg-calve-perthes-disease-overview.asp

  Legg-Calve-Perthes disease, also known as Perthes disease, is an uncommon pediatric hip disorder. It may cause a painless (or occasionally painful), intermittent limping and limited hip motion in growing children. […] Persistent limping as well as limited motion of the affected hip are what generally lead to a doctors evaluation and eventual referral to a pediatric orthopedic surgeon. […] During that time, the pediatric orthopedic surgeon will monitor the child through regular follow-up appointments every four to six months to check hip range of motion, gait (walking pattern) and pelvic radiographs (X-rays). […] Depending on the findings that result from the childs physical exam and X-rays, treatment will range from nonsteroidal anti-inflammatory medications (NSAIDs), such as ibuprofen, and activity modification (avoiding running and jumping activities) to physical therapy.

• #20 Legg-Calve-Perthes disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/diagnosis-treatment/drc-20374348

  Some children, especially very young ones, might need only conservative treatments or observation. Conservative treatments can include: […] Children with Perthes disease should not run, jump or take part in other high-impact activities that might speed up hip damage. […] Sometimes, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint. […] Stretching exercises can help keep the hip more flexible. […] Your healthcare professional might recommend infants’ or children’s medicines that you can buy without a prescription, such as ibuprofen (Advil, Motrin, others) to help relieve your child’s pain.

• #21 Legg-Calve-Perthes disease

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20374324

  In Perthes disease, the complete healing process can take several years. The types of treatment recommended depend on the: […] Some children need surgery to help keep the ball of the joint snug within the socket. This procedure might involve making wedge-shaped cuts in the thighbone or pelvis to align the joint again. […] Some children, especially very young ones, might need only conservative treatments or observation. Conservative treatments can include: […] Children with Perthes disease should not run, jump or take part in other high-impact activities that might speed up hip damage. […] Sometimes, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint. […] Stretching exercises can help keep the hip more flexible. […] Your healthcare professional might recommend infants’ or children’s medicines that you can buy without a prescription, such as ibuprofen (Advil, Motrin, others) to help relieve your child’s pain.

• #22 Legg-Calve-Perthes Disease | Texas Children’s

  https://www.texaschildrens.org/content/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease is treated by keeping the thighbone as round as possible and inside the socket. This is called containment. It lets the bone heal and makes sure the hip keeps good range of motion. […] Treatment may include: Bed rest, Limiting certain activities, like running, Physical therapy, Anti-inflammatory medicine to help with pain and stiffness in the hip, A cast or brace, Use of walker or crutches. […] If these methods do not work, surgery may be needed. The type of surgery depends on how bad the problem is and the shape of the ball in the hip joint. It may range from a procedure to make a groin muscle longer to osteotomy, a major surgery to reshape the pelvis. […] Early diagnosis and regular follow-up visits with an orthopedic specialist are important.

• #23 Legg-Calvé-Perthes Disease in Children

  https://healthinfo.universityhealthsystem.com/Search/90,P02768

  Legg-Calv-Perthes disease (or Perthes disease) is a rare hip condition that affects children. […] Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how bad the condition is. […] The goal of treatment is to keep the roundness of the femoral head and to prevent deformity while the condition runs its course. Treatment depends on the amount of hip pain and stiffness. It’s also based on X-ray changes over time and how much the femoral head has collapsed. […] The first step of treatment is usually to regain hip motion. It also tries to stop the pain that results from the tight muscles around the hip and the inflammation inside the joint. Treatment may include: […] Rest. Your child may need to limit activity. They may need crutches or a wheelchair. In some cases, your child may need bed rest.

• #24 When Your Child Has Legg-Calvé-Perthes Disease | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/when-your-child-has-legg-calve-perthes-disease

  Your child has been diagnosed with Legg-Calv-Perthes (LCP) disease. It is a problem with the head of the thighbone (femoral head). The femoral head is the ball-like part of the bone that fits into the hip socket. With LCP disease, the blood supply to the femoral head stops. The reason for this is unknown. As a result, the femoral head becomes weak, and a portion of it dies (avascular necrosis). […] LCP disease can be serious with, but it can be treated. Your child may see an orthopedist for evaluation and treatment. This is a health care provider who diagnoses and treats bone, muscle, and ligament problems. […] The health care provider will talk with you about the best treatment plan for your child. As instructed, your child should: […] Rest from sports and exercise. The provider will tell you when it is safe for your child to resume activities.

• #25 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  There are many treatment options for Perthes disease. Your doctor will consider several factors when developing a treatment plan for your child, including: Your child’s age. Younger children (age 6 and below) have a greater potential for developing a round femoral head after healing. […] Nonsurgical Treatment: Observation. For very young children (2 to 6 years old) who show few changes in the femoral head on their initial X-rays, the recommended treatment is usually simple observation. Your child’s doctor will regularly monitor your child using X-rays to make sure the regrowth of the femoral head is on track as the disease runs its course. […] Anti-inflammatory medications. Painful symptoms are caused by inflammation of the hip joint. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are used to reduce inflammation, and your child’s doctor may recommend them for several months.

• #26 Legg-Calve-Perthes (Perthes Disease): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/legg-calve-perthes-disease

  Nonsteroidal anti-inflammatory drugs (NSAIDs). These over-the-counter (OTC) medications can help manage pain and reduce inflammation in the hip joint. They include aspirin and ibuprofen. […] Physical therapy. A physical therapist will work with your child to rehabilitate their hip by prescribing special exercises. You might need to help your child practice their exercises. […] Traction. An orthopedic traction device applies gentle, progressive force to gradually stretch or pull the hip joint into alignment. This treatment takes place over a series of several days. […] Casts or braces. During the remodeling phase, your provider might suggest using a cast or brace to keep the bone fixed in the socket. The socket can help mold the bone as it regrows. […] Surgery. Some children might need surgery to help reshape and refit the bone in the socket. This is called osteotomy. Some might need arthroplasty to extend or reshape the hip socket.

• #27 When Your Child Has Legg-Calvé-Perthes Disease | Saint Luke’s Health System

  https://www.saintlukeskc.org/health-library/when-your-child-has-legg-calve-perthes-disease

  Take anti-inflammatory medicine, such as ibuprofen, as directed. […] Wear a cast or brace to support the leg while it heals. (This treatment is used for very young children.) […] Use crutches or a walker, if instructed. […] See a physical therapist (PT) for a supervised program of exercises. Your child’s physical therapist or provider may also ask your child to do strengthening exercises at home. […] Some injuries require surgery. Your child’s provider will talk with you about surgery if it’s needed.

• #28 Nonsurgical Treatment for Legg-Calvé-Perthes Disease in Children | NYU Langone Health

  https://nyulangone.org/conditions/legg-calve-perthes-disease-in-children/treatments/nonsurgical-treatment-for-legg-calve-perthes-disease-in-children

  Assistive devices, such as crutches, a walker, or a reclining wheelchair for traveling long distances, may be used to take pressure off of the hip and to prevent further injury to the joint. […] Medications such as bisphosphonates may be recommended to help rebuild bone in children older than age six who have Perthes disease. Anti-inflammatory medications may also be prescribed to reduce inflammation in the joint or tissues surrounding the hip joint.

• #29 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  Physical therapy exercises. Hip stiffness is common in children with Perthes disease and physical therapy exercises are recommended to help restore hip joint range of motion. […] Casting and bracing. If range of motion becomes limited, or if X-rays or other image scans indicate that a deformity is developing, a cast or brace may be used to keep the head of the femur in its normal position within the acetabulum. […] After the cast is removed, usually after 4 to 6 weeks, the child resumes physical therapy exercises to restore motion in the hips and knees. […] Your child’s doctor may recommend surgery to re-establish the proper alignment of the bones of the hip and to keep the head of the femur deep within the acetabulum until healing is complete. […] After the cast is removed: Your child will need physical therapy to restore muscle strength and range of motion. They will also need crutches or a walker to reduce weightbearing on the affected hip. […] In most cases, the long-term prognosis for children with Perthes is good and they grow into adulthood without further hip problems.

• #30 Legg-Calve-Perthes disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/diagnosis-treatment/drc-20374348

  Our caring team of Mayo Clinic experts can help you with your Legg-Calve-Perthes disease-related health concerns […] In Perthes disease, the complete healing process can take several years. The types of treatment recommended depend on the: […] As Perthes disease gets worse, the ball part of the joint, called the femoral head, weakens and breaks apart. During healing, the socket part of the joint can serve as a mold. This can help the weakened femoral head keep its round shape. […] For this molding to work, the femoral head must sit snugly within the socket. Sometimes a child wears a special type of leg cast that spreads the legs widely apart for 4 to 6 weeks to keep the bone in the right position. […] Some children need surgery to help keep the ball of the joint snug within the socket. This procedure might involve making wedge-shaped cuts in the thighbone or pelvis to align the joint again.

• #31 Nonsurgical Treatment for Legg-Calvé-Perthes Disease in Children | NYU Langone Health

  https://nyulangone.org/conditions/legg-calve-perthes-disease-in-children/treatments/nonsurgical-treatment-for-legg-calve-perthes-disease-in-children

  Doctors at Hassenfeld Childrens Hospital at NYU Langone focus on identifying and treating Legg-Calv-Perthes disease, also called Perthes disease, before the ball of the hip joint, or femoral head, becomes misshapen. Nonsurgical treatments are often highly effective in helping a young childs hip joint to heal properly. When started early, these treatments can also help to prevent long-term complications, such as arthritis. […] Physical therapy is usually the first treatment for children with mild symptoms of Perthes disease and typically begins as soon as a child has been diagnosed. Physical therapy can help to restore range of motion in the hip joint, reduce inflammation and pain, and protect the joint as it heals. […] Occasionally, our doctors may recommend using a removable Petrie cast to keep the ball of the hip joint embedded in the socket as the joint heals.

• #32 Legg-Calve-Perthes Disease: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/legg-calve-perthes-disease-maxs-story

  When Max, an active, sports-obsessed 7-year-old, experienced leg pain, it seemed like a simple pulled muscle. […] The pediatrician suspected Legg-Calve-Perthes disease, a rare disorder that deforms the femur, causing significant pain and lost flexibility at the hip. […] Their first consultation at CHOP confirmed the diagnosis of Legg-Calve Perthes disease. […] Max spent six weeks in an A-frame cast to ensure proper positioning while his hip joint healed. […] The local orthopedist warned the family that Max might not be able to run or jump for three years during his treatment and healing. […] The goal of treatment was to contain the femoral head while it regrew and help it retain its round shape to fit into the hip socket properly. […] Max had physical therapy once or twice a week and got X-rays every three months to monitor the healing progress in his femur and hip joint.

• #33 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  Physical therapy exercises. Hip stiffness is common in children with Perthes disease and physical therapy exercises are recommended to help restore hip joint range of motion. […] Casting and bracing. If range of motion becomes limited, or if X-rays or other image scans indicate that a deformity is developing, a cast or brace may be used to keep the head of the femur in its normal position within the acetabulum. […] After the cast is removed, usually after 4 to 6 weeks, the child resumes physical therapy exercises to restore motion in the hips and knees. […] Your child’s doctor may recommend surgery to re-establish the proper alignment of the bones of the hip and to keep the head of the femur deep within the acetabulum until healing is complete. […] After the cast is removed: Your child will need physical therapy to restore muscle strength and range of motion. They will also need crutches or a walker to reduce weightbearing on the affected hip. […] In most cases, the long-term prognosis for children with Perthes is good and they grow into adulthood without further hip problems.

• #34 Legg-Calve-Perthes Disease | Boston Children’s Hospital

  https://www.childrenshospital.org/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease (also known as Perthes disease) is a rare condition in which the ball-shaped head of the thighbone (femoral head) temporarily loses its blood supply. As a result, the head of the thighbone collapses, and the area becomes inflamed and irritated. […] Your child’s treatment will depend on their age, range of motion in their hip, and extent of the condition. Your child’s orthopedic specialist will recommend a treatment based on the degree of your child’s hip pain, stiffness, and how much of the head of the thighbone has collapsed. […] Non-surgical approaches to treatment may include: Activity restrictions, Anti-inflammatory medication, Bed rest and traction, Casting or bracing to: Hold the head of the thighbone in the hip socket, Permit limited joint movement, Allow the thighbone to remold itself into a round shape, Physical therapy, to keep the hip muscles strong and promote hip movement.

• #35 Symptoms, Causes and Treatment of Perthes Disease | HSS

  https://www.hss.edu/conditions_legg-calve-perthes-disease-overview.asp

  Physical therapists play an important role in the care of patients with Perthes. The physical therapist will work with the child on range of motion and strengthening exercises for the lower extremities, as maintaining strength of the lower extremities and range of motion of the affected hip is very important in the rehabilitation of a child with Perthes disease.

• #36 Legg-Calve-Perthes disease – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/diagnosis-treatment/drc-20374348

  Some children, especially very young ones, might need only conservative treatments or observation. Conservative treatments can include: […] Children with Perthes disease should not run, jump or take part in other high-impact activities that might speed up hip damage. […] Sometimes, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint. […] Stretching exercises can help keep the hip more flexible. […] Your healthcare professional might recommend infants’ or children’s medicines that you can buy without a prescription, such as ibuprofen (Advil, Motrin, others) to help relieve your child’s pain.

• #37 Legg-Calve-Perthes disease

  https://johnsonmemorial.org/jmh-health/disease-conditions/con-20374324

  In Perthes disease, the complete healing process can take several years. The types of treatment recommended depend on the: […] Some children need surgery to help keep the ball of the joint snug within the socket. This procedure might involve making wedge-shaped cuts in the thighbone or pelvis to align the joint again. […] Some children, especially very young ones, might need only conservative treatments or observation. Conservative treatments can include: […] Children with Perthes disease should not run, jump or take part in other high-impact activities that might speed up hip damage. […] Sometimes, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint. […] Stretching exercises can help keep the hip more flexible. […] Your healthcare professional might recommend infants’ or children’s medicines that you can buy without a prescription, such as ibuprofen (Advil, Motrin, others) to help relieve your child’s pain.

• #38 Legg Calve Perthes Disease (LCP) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease, often called Perthes disease, is an uncommon condition in children affecting the hip. […] The main focus in treating Legg-Calve-Perthes disease is to maintain as much bone in the femoral head and keep it as round as possible. The younger the child and the least amount of bone damage provide the child with the best outcome in keeping a healthy hip joint and avoiding pain, stiffness and arthritis. It is important for children and parents to follow the instructions regarding activities and exercise provided by the specialists. […] In more severe cases, some children require surgery to improve the hip joint movement and help reduce pain. If your child should require surgery, the doctor will discuss the type of surgery, recovery time, and expected results from the surgery.

• #39 Legg-Calve-Perthes Disease | Pediatric Orthopaedic Society of North America (POSNA)

  https://posna.org/physician-education/study-guide/legg-calve-perthes-disease

  Containment treatment, which means to position the anterior-lateral portion of the femoral epiphysis within the acetabulum in order to prevent deformation, can be performed through either operative or non-operative means. […] Non-operative containment can be achieved through Petrie casting and abduction bracing. […] Surgical containment can be achieved through either varus-producing intertrochanteric femoral osteotomy or pelvic osteotomy. […] Patients with residual deformity after healed Perthes disease may have anatomic deformities including femoral-acetabular impingement (FAI) and acetabular dysplasia. […] Treatment is aimed at repairing or minimizing these residual deformities. […] When these treatment options fail, total hip replacement may be required.

• #40

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Treatment is typically observation in children less than 8 years of age, and femoral and/or pelvic osteotomy in children greater than 8 years of age. […] Nonoperative observation alone, activity restriction (non-weightbearing), and physical therapy (ROM exercises) are indicated for children, as young patients typically do not benefit from surgery. […] The main goals of treatment are to keep the femoral head contained and maintain good motion, as containment limits deformity and minimizes loss of sphericity, thereby lessening subsequent degenerative changes. […] All patients require periodic clinical and radiographic follow-up until completion of the disease process. […] Good outcomes correlate with a spherical femoral head, with 60% of patients not requiring operative intervention. […] Operative treatment includes femoral and/or pelvic osteotomy, indicated for children 8 years of age, especially those with lateral pillar B and B/C involvement. […] Studies suggest that earlier surgery before femoral head deformity develops may be best.

• #41 Legg-Calve-Perthes Disease – Lower Extremity Disorders for Medicine

  https://www.picmonic.com/pathways/medicine/courses/standard/musculoskeletal-orthopedics-10681/lower-extremity-disorders-39068/legg-calve-perthes-disease_8416

  Hip bracing or casting in abduction with a Petrie cast may be used to contain the femur within the acetabulum if the patient is developing a severe deformity, has extensive disease or a decreased range of motion. […] Surgery is recommended for children above age eight, when greater than 50% of the femur is damaged, and when patients fail conservative therapy. An osteotomy, the most common type of corrective surgery for LCPD, helps to realign the femoral head within the acetabulum and increase range of motion.

• #42 Legg-Calve-Perthes Disease | Texas Children’s

  https://www.texaschildrens.org/content/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease is treated by keeping the thighbone as round as possible and inside the socket. This is called containment. It lets the bone heal and makes sure the hip keeps good range of motion. […] Treatment may include: Bed rest, Limiting certain activities, like running, Physical therapy, Anti-inflammatory medicine to help with pain and stiffness in the hip, A cast or brace, Use of walker or crutches. […] If these methods do not work, surgery may be needed. The type of surgery depends on how bad the problem is and the shape of the ball in the hip joint. It may range from a procedure to make a groin muscle longer to osteotomy, a major surgery to reshape the pelvis. […] Early diagnosis and regular follow-up visits with an orthopedic specialist are important.

• #43 Pediatric Legg-Calvé-Perthes Disease | Memorial Hermann

  https://memorialhermann.org/services/conditions/pediatric-legg-calve-perthes-disease

  In addition to therapeutic treatment, surgery is another option to consider. There are several approaches to surgery, which include: […] With contracture release, surgery is used to lengthen the hip muscles and tendons that have shortened and caused the hip to pull inward. […] Surgery for joint realignment focuses on restoring the normal shape of the hip joint, using small cuts in the femur bone or pelvis to realign the joints. […] For patients with restricted movement, it may be helpful to remove any extra bone or damaged cartilage from the joint using realignment surgery to alleviate pain and to regain additional joint movement. […] Joint replacement surgery may be required at some point due to the degenerative effects of the disease on the hip joints.

• #44 Perthes Disease (Legg-Calve-Perthes Disease) – Treatment

  https://davidslattery.com/hip-conditions/perthes-disease/treatment/

  Avoiding high impact activities, such as running and jumping, will help relieve pain and protect the femoral head. Crutches or a walker may be used to prevent your child from putting too much weight on the joint. […] Hip stiffness is common in children with Perthes disease and physiotherapy exercises are recommended to help restore and maintain hip joint range of motion. Parents or other caregivers are needed to help the child complete the exercises. […] If range of motion becomes limited or if x-rays or other image scans indicate that a deformity is developing, a cast or brace may be used to keep the head of the femur in its normal position within the acetabulum. […] Surgical realignment of the bones (either femur(thighbone) or pelvis (hip bone)) is most often recommended when: […] The most common surgical procedure for treating Perthes disease is an osteotomy. In this type of procedure, the bone is cut and repositioned to keep the femoral head within the acetabulum. This alignment is kept in place with screws and plates, which will be removed after the healed stage of the disease.

• #45 Legg-Calve-Perthes Disease Treatment & Management: Medical Therapy, Surgical Therapy, Complications

  https://emedicine.medscape.com/article/1248267-treatment

  Consultation with an orthopedist is recommended. Goals in the treatment of Legg-Calv-Perthes disease (LCPD) include the following: Eliminating hip irritability […] Initial therapy includes minimal weightbearing and protection of the joint, which is accomplished by maintaining the femur abducted and internally rotated so that the femoral head is held well inside the rounded portion of the acetabulum. Abduction and rotation of the femur are accomplished by means of either the use of orthotic devices (bracing) or surgery (osteotomy). The Scottish Rite brace achieves containment by abduction while allowing free knee motion. […] Results of surgical containment appear to be better than those of nonsurgical containment (orthosis). Surgery does not speed healing of the femoral head, but it does cause the head to reossify in a more spherical fashion.

• #46

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Treatment is typically observation in children less than 8 years of age, and femoral and/or pelvic osteotomy in children greater than 8 years of age. […] Nonoperative observation alone, activity restriction (non-weightbearing), and physical therapy (ROM exercises) are indicated for children, as young patients typically do not benefit from surgery. […] The main goals of treatment are to keep the femoral head contained and maintain good motion, as containment limits deformity and minimizes loss of sphericity, thereby lessening subsequent degenerative changes. […] All patients require periodic clinical and radiographic follow-up until completion of the disease process. […] Good outcomes correlate with a spherical femoral head, with 60% of patients not requiring operative intervention. […] Operative treatment includes femoral and/or pelvic osteotomy, indicated for children 8 years of age, especially those with lateral pillar B and B/C involvement. […] Studies suggest that earlier surgery before femoral head deformity develops may be best.

• #47 Legg-Calve-Perthes disease – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/care-at-mayo-clinic/mac-20374355

  At Mayo Clinic, orthopedic surgeons work with radiologists, physical therapists and other specialists to evaluate and treat people with Legg-Calve-Perthes disease. This means that you’re getting more than just one opinion you benefit from the knowledge and experience of each specialist on the multidisciplinary team. […] Perfusion MRI is an option at Mayo Clinic. This advanced form of MRI can show how much blood is getting to the femoral head, which helps in choosing appropriate treatments for children with Legg-Calve-Perthes disease. The latest surgical techniques are available, as are physical therapists who specialize in the care of children. […] Pediatric orthopedic surgeons collaborate closely with adult hip surgeons to provide the full complement of care for adolescents with Legg-Calve-Perthes disease.

• #48 Legg-Calvé-Perthes Disease Care at Gillette Children’s

  https://www.gillettechildrens.org/conditions-care/perthes-care-at-gillette

  The Gillette care team is focused on the patient and family. Our approach to Legg-Calv-Perthes disease care is interdisciplinary, offering not only orthopedic care but meeting the other physical, psychological, and functional needs of the patient and family, as well. […] A new Perthes diagnosis can be an overwhelming time for a patient and family our care team is ready to answer questions and support you through this process. […] The Gillette Perthes Clinics, in Saint Paul and Maple Grove, are dedicated times for seeing patients with Perthes disease. Our providers also see patients in Burnsville. We have physical therapy and radiology services in Saint Paul, Maple Grove and Burnsville.

• #49 Legg-Calvé-Perthes disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2183170/

  Legg-Calv-Perthes disease is a disease occurring in otherwise healthy children. An understanding of the physiologic process of the disease and the purpose of various forms of treatment is essential for nurses caring for these children and their families. Nurses are in a position to assist the child and family to cope with the alterations in lifestyle that result from treatment of Perthes disease. […] Legg-Calve-Perthes Disease / nursing* […] Nursing Assessment […] Legg-Calve-Perthes Disease / therapy […] Femur Head Necrosis / nursing*

• #50 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  The patient may still take part in physical therapy. […] Literature does not support the use of orthotics, braces, or casts. […] Referral to an experienced pediatric orthopedist is recommended. […] Good outcomes reported in up to 60% of patients. […] LCPD has no cure, and the disorder is best managed by an interprofessional team that also includes the orthopedic nurse. […] For children with mild disease, non-surgical treatment is recommended with activity restriction and protective weight-bearing until ossification is complete. […] To improve patient outcomes, all cases should be referred to a pediatric orthopedic surgeon as soon as the diagnosis is made. […] AN orthopedic specialty nurse can help coordinate PT for the patient, along with palliative pharmaceutical care (NSAIDs), and monitor the case for the orthopedist in-between visits. […] These patients need long follow up as deformities of the femoral head can develop.

• #51 Legg-Calve-Perthes disease – Care at Mayo Clinic – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legg-calve-perthes-disease/care-at-mayo-clinic/mac-20374355

  At Mayo Clinic, orthopedic surgeons work with radiologists, physical therapists and other specialists to evaluate and treat people with Legg-Calve-Perthes disease. This means that you’re getting more than just one opinion you benefit from the knowledge and experience of each specialist on the multidisciplinary team. […] Perfusion MRI is an option at Mayo Clinic. This advanced form of MRI can show how much blood is getting to the femoral head, which helps in choosing appropriate treatments for children with Legg-Calve-Perthes disease. The latest surgical techniques are available, as are physical therapists who specialize in the care of children. […] Pediatric orthopedic surgeons collaborate closely with adult hip surgeons to provide the full complement of care for adolescents with Legg-Calve-Perthes disease.

• #52 Legg-Calvé-Perthes Disease | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/legg-calve-perthes/

  By working together as a team, we are able to develop a comprehensive approach to both patient diagnosis and individualized treatment plans. Specialists from our Hip Preservation Program offer a broad spectrum of options for our patients and extend to include experts in the fields of rehabilitation, physical therapy, rheumatology, anesthesiology and pain.

• #53 Legg-Calve-Perthes Disease: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/legg-calve-perthes-disease-maxs-story

  While the results were certainly worth it, the treatment was a physical ordeal for Max and emotionally difficult for both him and his family. […] We were lucky to have access to good mental health care for all of us, including the child life team at CHOP. […] The child life team gave Max a list of items that would be helpful for other youth, and he and his family set to work getting donations.

• #54 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  The patient may still take part in physical therapy. […] Literature does not support the use of orthotics, braces, or casts. […] Referral to an experienced pediatric orthopedist is recommended. […] Good outcomes reported in up to 60% of patients. […] LCPD has no cure, and the disorder is best managed by an interprofessional team that also includes the orthopedic nurse. […] For children with mild disease, non-surgical treatment is recommended with activity restriction and protective weight-bearing until ossification is complete. […] To improve patient outcomes, all cases should be referred to a pediatric orthopedic surgeon as soon as the diagnosis is made. […] AN orthopedic specialty nurse can help coordinate PT for the patient, along with palliative pharmaceutical care (NSAIDs), and monitor the case for the orthopedist in-between visits. […] These patients need long follow up as deformities of the femoral head can develop.

• #55 Legg Calve Perthes Disease (LCP) | Nationwide Children’s Hospital

  https://www.nationwidechildrens.org/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease, often called Perthes disease, is an uncommon condition in children affecting the hip. […] The main focus in treating Legg-Calve-Perthes disease is to maintain as much bone in the femoral head and keep it as round as possible. The younger the child and the least amount of bone damage provide the child with the best outcome in keeping a healthy hip joint and avoiding pain, stiffness and arthritis. It is important for children and parents to follow the instructions regarding activities and exercise provided by the specialists. […] In more severe cases, some children require surgery to improve the hip joint movement and help reduce pain. If your child should require surgery, the doctor will discuss the type of surgery, recovery time, and expected results from the surgery.

• #56 Legg-Calvé-Perthes Disease – Seattle Children’s

  https://www.seattlechildrens.org/conditions/legg-calve-perthes-disease/

  Your child’s team may do surgery to: […] Tilt the ball so it is deeper in the socket […] Rotate the socket so it will cover the ball better when your child walks […] Release a tendon in the groin to improve range of motion. […] Your child’s team will check for signs of problems and also make sure you know what signs to watch for and when to call the doctor. […] Having a child with Perthes disease can be stressful for the whole family. From the first visit to follow-up, our team will work to give your child seamless care and make your experience here as easy on you as we can. […] Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options. We support you in making choices that are right for your family.

• #57 Understanding a painful, little-known condition in children: Perthes disease | Nursing in Practice

  https://www.nursinginpractice.com/clinical/paediatrics/identifying-dealing-painful-little-known-condition-children-perthes-disease/

  Children present with pain in their hips, groin, legs and/or knees (this may be referred hip pain). […] The main emphasis is on allowing Perthes disease to progress through all its stages, and in order to do that we need to create the ideal environment for the hip. […] From a non-surgical point of view the key thing for my patients is to try and maintain as much activity as possible without causing any further damage to the hip joint, in order to maintain a good degree of strength and muscle length in the hip joint. […] The last thing we want to be saying is you cant do this were working on pain-free movement, just avoiding excessive force. […] Its vitally important that all professionals, from the earliest stages on, can recognise the symptoms and the profile of children whore most likely to have Perthes disease, and that they encourage a formal diagnosis in order to reduce the risk of unnecessary pain and possibly permanent damage.

• #58 ALL YOU NEED TO KNOW ABOUT LEGG–CALVÉ–PERTHES DISEASE: SYMPTOMS, CAUSES, AND TREATMENT | Mya Care

  https://myacare.com/blog/all-you-need-to-know-about-legg-calve-perthes-disease-symptoms-causes-and-treatment

  Surgery is usually performed to retain the shape and function of the hip joint and lower the risk of arthritis or total immobility later in life. […] The choice of treatment for LCPD depends on several factors, such as the child’s age, the stage and severity of the disease, the shape of the femoral head, the preference of the doctor and the family, and the availability of resources. […] Therefore, it is important for children with LCPD and their families to have regular follow-ups and consultations with their doctor and to seek support and guidance from other health professionals, such as physical therapists, orthotists, psychologists, or social workers.

• #59 Legg-Calve-Perthes (Perthes Disease): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/legg-calve-perthes-disease

  If your child has developed Legg-Calve Perthes, you can expect a healthcare journey of several years, with different phases in it. This will intrude on their childhood, to some extent less for some than others. But when it’s over, most can return to their activities without limitations or ongoing symptoms. […] Kids who don’t get the right treatment at the right time, and whose femur bones remain deformed, can develop hip osteoarthritis later in life.

• #60 Legg-Calve-Perthes Disease | Texas Children’s

  https://www.texaschildrens.org/content/conditions/legg-calve-perthes-disease

  Legg-Calve-Perthes disease is treated by keeping the thighbone as round as possible and inside the socket. This is called containment. It lets the bone heal and makes sure the hip keeps good range of motion. […] Treatment may include: Bed rest, Limiting certain activities, like running, Physical therapy, Anti-inflammatory medicine to help with pain and stiffness in the hip, A cast or brace, Use of walker or crutches. […] If these methods do not work, surgery may be needed. The type of surgery depends on how bad the problem is and the shape of the ball in the hip joint. It may range from a procedure to make a groin muscle longer to osteotomy, a major surgery to reshape the pelvis. […] Early diagnosis and regular follow-up visits with an orthopedic specialist are important.

• #61 FloridaHealthFinder | Legg-Calve-Perthes disease | Health Encyclopedia | FloridaHealthFinder

  https://quality.dev.healthfinder.fl.gov/health-encyclopedia/HIE/1/001264

  Legg-Calve-Perthes disease occurs when the ball of the thigh bone in the hip does not get enough blood, causing the bone to die. […] The goal of treatment is to keep the ball of the thigh bone inside the socket. The provider may call this containment. The reason for doing this is to make sure the hip continues to have good range of motion. […] The treatment plan may involve: A short period of bed rest to help with severe pain, Limiting the amount of weight placed on the leg by restricting activities such as running, Physical therapy to help keep the leg and hip muscles strong, Taking anti-inflammatory medicine, such as ibuprofen, to relieve stiffness in the hip joint, Wearing a cast or brace to help with containment, Using crutches or a walker. […] It is important for the child to have regular follow-up visits with the provider and an orthopedic specialist.

• #62

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Treatment is typically observation in children less than 8 years of age, and femoral and/or pelvic osteotomy in children greater than 8 years of age. […] Nonoperative observation alone, activity restriction (non-weightbearing), and physical therapy (ROM exercises) are indicated for children, as young patients typically do not benefit from surgery. […] The main goals of treatment are to keep the femoral head contained and maintain good motion, as containment limits deformity and minimizes loss of sphericity, thereby lessening subsequent degenerative changes. […] All patients require periodic clinical and radiographic follow-up until completion of the disease process. […] Good outcomes correlate with a spherical femoral head, with 60% of patients not requiring operative intervention. […] Operative treatment includes femoral and/or pelvic osteotomy, indicated for children 8 years of age, especially those with lateral pillar B and B/C involvement. […] Studies suggest that earlier surgery before femoral head deformity develops may be best.

• #63 Legg Calve Perthes Disease (LCP)

  https://www.nationwidechildrens.org/conditions/legg-calve-perthes-disease-lcp

  Legg Calve Perthes disease goes through several stages over a course of several years. […] LCP is often treated with observation, particularly in the younger child. Often, the child will be placed on crutches or a walker to help prevent weight being placed on the affected hip. Anti-inflammatory medicines, like ibuprofen (Advil) and naproxen (Aleve), rest, changes in activity (such as avoiding high-impact activities like running and jumping), and physical therapy are also standard treatment options. […] If non-surgical treatment has not been successful, or the femoral head has not grown back as it should, surgery may be needed. Your child’s age and severity of the disease determines the specific surgical treatment used. […] Cast, crutches or a walker and an abduction pillow may be used after surgery to help keep the hip in the proper position and promote healing. […] You and your child can expect to have regular follow-up appointments with your child’s orthopedic doctor until your child is skeletally mature (has finished growing).

• #64 Legg-Calve-Perthes Disease: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/826935-overview

  The prognosis for patients with LCPD can be good; it depends on the completeness of involvement of the epiphyseal center. The severity of involvement of the femoral head, its subsequent healing, and proper joint space preservation all help determine when and to what degree an athlete will be able to participate in sports. The functional result depends on the amount of deformity that develops when the structure is softened. Overall, the prognosis for recovery and sports participation after treatment is very good for most individuals.

• #65 Perthes Disease (Legg-Calve-Perthes Disease) – Treatment

  https://davidslattery.com/hip-conditions/perthes-disease/treatment/

  In most cases, the long-term prognosis for children with Perthes is good. However, if there is deformity in the shape of the femoral head, there is the potential for future problems. If the deformed head still fits into the acetabulum, problems may be avoided. In cases where the deformed head does not fit well into the acetabulum, hip pain or early onset of arthritis is likely in adulthood.

• #66 Perthes Disease – Legg-Calve-Perthes – OrthoInfo – AAOS

  https://orthoinfo.aaos.org/en/diseases–conditions/perthes-disease/

  Physical therapy exercises. Hip stiffness is common in children with Perthes disease and physical therapy exercises are recommended to help restore hip joint range of motion. […] Casting and bracing. If range of motion becomes limited, or if X-rays or other image scans indicate that a deformity is developing, a cast or brace may be used to keep the head of the femur in its normal position within the acetabulum. […] After the cast is removed, usually after 4 to 6 weeks, the child resumes physical therapy exercises to restore motion in the hips and knees. […] Your child’s doctor may recommend surgery to re-establish the proper alignment of the bones of the hip and to keep the head of the femur deep within the acetabulum until healing is complete. […] After the cast is removed: Your child will need physical therapy to restore muscle strength and range of motion. They will also need crutches or a walker to reduce weightbearing on the affected hip. […] In most cases, the long-term prognosis for children with Perthes is good and they grow into adulthood without further hip problems.

• #67

  https://www.orthobullets.com/pediatrics/4119/legg-calve-perthes-disease

  Legg-Calve-Perthes Disease is an idiopathic avascular necrosis of the proximal femoral epiphysis in children. […] Treatment is typically observation in children less than 8 years of age, and femoral and/or pelvic osteotomy in children greater than 8 years of age. […] Nonoperative observation alone, activity restriction (non-weightbearing), and physical therapy (ROM exercises) are indicated for children, as young patients typically do not benefit from surgery. […] The main goals of treatment are to keep the femoral head contained and maintain good motion, as containment limits deformity and minimizes loss of sphericity, thereby lessening subsequent degenerative changes. […] All patients require periodic clinical and radiographic follow-up until completion of the disease process. […] Good outcomes correlate with a spherical femoral head, with 60% of patients not requiring operative intervention. […] Operative treatment includes femoral and/or pelvic osteotomy, indicated for children 8 years of age, especially those with lateral pillar B and B/C involvement. […] Studies suggest that earlier surgery before femoral head deformity develops may be best.

• #68 Legg-Calvé-Perthes Disease in Children – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=legg-calv-perthes-disease-in-children-90-P02768

  Casting or bracing. This treatment can hold the femoral head in the hip socket. It also lets your child move the joint a bit and allows the femur to remold itself into a round shape. […] Surgery. Your child may need surgery to hold the femoral head in the hip socket. […] Physical therapy. This treatment can keep the hip muscles strong and promote hip movement. […] The more severe the case, the greater the likelihood that your child may have limited hip motion, differences in leg lengths, and other hip problems in adulthood. […] Treatment goals include controlling pain, maintaining hip motion, and keeping the hip deformity from getting worse.

• #69 Legg-Calve-Perthes (Perthes Disease): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/legg-calve-perthes-disease

  If your child has developed Legg-Calve Perthes, you can expect a healthcare journey of several years, with different phases in it. This will intrude on their childhood, to some extent less for some than others. But when it’s over, most can return to their activities without limitations or ongoing symptoms. […] Kids who don’t get the right treatment at the right time, and whose femur bones remain deformed, can develop hip osteoarthritis later in life.

• #70 Legg-Calve-Perthes (Perthes Disease): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/legg-calve-perthes-disease

  If your child has developed Legg-Calve Perthes, you can expect a healthcare journey of several years, with different phases in it. This will intrude on their childhood, to some extent less for some than others. But when it’s over, most can return to their activities without limitations or ongoing symptoms. […] Kids who don’t get the right treatment at the right time, and whose femur bones remain deformed, can develop hip osteoarthritis later in life.

• #71 Legg-Calve-Perthes Disease | Symptoms, Diagnosis, and Treatment

  https://www.cincinnatichildrens.org/health/l/legg-calve-perthes-disease

  Physical therapy. This can help stretch muscles that are tight, strengthen muscles around the hip and work on walking to reduce limping. […] Surgery. This is a two-stage procedure. These procedures are done six weeks apart. […] For about two years, the child will be restricted from many activities including running and jumping. Even after LCPD / AVN has resolved, it is best if your child avoids contact and collision activities. They should also avoid running and cutting sports. Children with this condition do well with low-impact activities like biking and swimming.

• #72 Legg-Calve-Perthes Disease | Symptoms, Diagnosis, and Treatment

  https://www.cincinnatichildrens.org/health/l/legg-calve-perthes-disease

  Physical therapy. This can help stretch muscles that are tight, strengthen muscles around the hip and work on walking to reduce limping. […] Surgery. This is a two-stage procedure. These procedures are done six weeks apart. […] For about two years, the child will be restricted from many activities including running and jumping. Even after LCPD / AVN has resolved, it is best if your child avoids contact and collision activities. They should also avoid running and cutting sports. Children with this condition do well with low-impact activities like biking and swimming.

• #73 Legg-Calvé-Perthes Disease

  https://www.cookchildrens.org/services/orthopedics/conditions/legg-calve-perthes/

  Treatment may include: […] Medicine for pain and inflammation […] Putting less weight on the hip joint. Kids usually need to stop running and jumping for a while. Some kids may need to use crutches or a walker for a few weeks or months. […] Wearing a brace or cast […] Physical therapy (pt) […] Some children with Perthes disease may need surgery. Sometimes the leg affected by Perthes disease is shorter and may need either a lift in the shoe or, rarely, surgery. […] Most children with Perthes disease will heal well and have no long-term problems. The degree of recovery depends on how much of the bone is involved. Kids who have only a small area of bone affected tend to heal the best. Also, younger children tend to heal better than older kids.

• #74 Perthes Disease (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/perthes-disease.html

  Legg-Calv-Perthes disease is a problem that changes the shape of the top of the thighbone (femur). The bone doesnt fit into the hip joint normally, causing pain and limping. […] Most children with Perthes disease heal well with no long-term problems. […] Treatment goals are to ease pain, help with hip movement, and help the bone grow back to a normal shape. […] The kind of treatments needed depend on a childs age and the amount and type of changes in the thighbone. […] The orthopedic specialist may recommend: medicine for pain and inflammation (irritation and swelling), physical therapy (PT), limiting activity, casting or bracing, surgery. […] Treatment for Legg-Calv-Perthes can last for several years. X-rays are done at follow-up visits to show how the bone is healing.

• #75 Legg-Calve-Perthes Disease: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/legg-calve-perthes-disease-maxs-story

  While the results were certainly worth it, the treatment was a physical ordeal for Max and emotionally difficult for both him and his family. […] We were lucky to have access to good mental health care for all of us, including the child life team at CHOP. […] The child life team gave Max a list of items that would be helpful for other youth, and he and his family set to work getting donations.

• #76 Legg-Calve-Perthes (Perthes Disease): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/legg-calve-perthes-disease

  If your child has developed Legg-Calve Perthes, you can expect a healthcare journey of several years, with different phases in it. This will intrude on their childhood, to some extent less for some than others. But when it’s over, most can return to their activities without limitations or ongoing symptoms. […] Kids who don’t get the right treatment at the right time, and whose femur bones remain deformed, can develop hip osteoarthritis later in life.

• #77 Legg-Calve-Perthes Disease: Max’s Story | Children’s Hospital of Philadelphia

  https://www.chop.edu/stories/legg-calve-perthes-disease-maxs-story

  While the results were certainly worth it, the treatment was a physical ordeal for Max and emotionally difficult for both him and his family. […] We were lucky to have access to good mental health care for all of us, including the child life team at CHOP. […] The child life team gave Max a list of items that would be helpful for other youth, and he and his family set to work getting donations.

• #78 Legg-Calvé-Perthes Disease – Seattle Children’s

  https://www.seattlechildrens.org/conditions/legg-calve-perthes-disease/

  Your child’s team may do surgery to: […] Tilt the ball so it is deeper in the socket […] Rotate the socket so it will cover the ball better when your child walks […] Release a tendon in the groin to improve range of motion. […] Your child’s team will check for signs of problems and also make sure you know what signs to watch for and when to call the doctor. […] Having a child with Perthes disease can be stressful for the whole family. From the first visit to follow-up, our team will work to give your child seamless care and make your experience here as easy on you as we can. […] Your child’s team does more than plan and provide care for your child. We also make sure you and your child understand your child’s condition and treatment options. We support you in making choices that are right for your family.

• #79 Legg-Calvé-Perthes disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/2183170/

  Legg-Calv-Perthes disease is a disease occurring in otherwise healthy children. An understanding of the physiologic process of the disease and the purpose of various forms of treatment is essential for nurses caring for these children and their families. Nurses are in a position to assist the child and family to cope with the alterations in lifestyle that result from treatment of Perthes disease. […] Legg-Calve-Perthes Disease / nursing* […] Nursing Assessment […] Legg-Calve-Perthes Disease / therapy […] Femur Head Necrosis / nursing*

• #80 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  The patient may still take part in physical therapy. […] Literature does not support the use of orthotics, braces, or casts. […] Referral to an experienced pediatric orthopedist is recommended. […] Good outcomes reported in up to 60% of patients. […] LCPD has no cure, and the disorder is best managed by an interprofessional team that also includes the orthopedic nurse. […] For children with mild disease, non-surgical treatment is recommended with activity restriction and protective weight-bearing until ossification is complete. […] To improve patient outcomes, all cases should be referred to a pediatric orthopedic surgeon as soon as the diagnosis is made. […] AN orthopedic specialty nurse can help coordinate PT for the patient, along with palliative pharmaceutical care (NSAIDs), and monitor the case for the orthopedist in-between visits. […] These patients need long follow up as deformities of the femoral head can develop.

• #81 Legg-Calve-Perthes Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK513230/

  The patient may still take part in physical therapy. […] Literature does not support the use of orthotics, braces, or casts. […] Referral to an experienced pediatric orthopedist is recommended. […] Good outcomes reported in up to 60% of patients. […] LCPD has no cure, and the disorder is best managed by an interprofessional team that also includes the orthopedic nurse. […] For children with mild disease, non-surgical treatment is recommended with activity restriction and protective weight-bearing until ossification is complete. […] To improve patient outcomes, all cases should be referred to a pediatric orthopedic surgeon as soon as the diagnosis is made. […] AN orthopedic specialty nurse can help coordinate PT for the patient, along with palliative pharmaceutical care (NSAIDs), and monitor the case for the orthopedist in-between visits. […] These patients need long follow up as deformities of the femoral head can develop.

• #82 Understanding a painful, little-known condition in children: Perthes disease | Nursing in Practice

  https://www.nursinginpractice.com/clinical/paediatrics/identifying-dealing-painful-little-known-condition-children-perthes-disease/

  Children present with pain in their hips, groin, legs and/or knees (this may be referred hip pain). […] The main emphasis is on allowing Perthes disease to progress through all its stages, and in order to do that we need to create the ideal environment for the hip. […] From a non-surgical point of view the key thing for my patients is to try and maintain as much activity as possible without causing any further damage to the hip joint, in order to maintain a good degree of strength and muscle length in the hip joint. […] The last thing we want to be saying is you cant do this were working on pain-free movement, just avoiding excessive force. […] Its vitally important that all professionals, from the earliest stages on, can recognise the symptoms and the profile of children whore most likely to have Perthes disease, and that they encourage a formal diagnosis in order to reduce the risk of unnecessary pain and possibly permanent damage.

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