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Legg-Calve-Perthes' Disease

more about Legg-Calve-Perthes' Disease

Coxa plana or Perthes disease

  • Legg-Calve-Perthes disease is a self-limiting disorder characterized by a loss of blood supply to the femoral head, leading to avascular necrosis.

  • The onset occurs between the ages of 5 and 10.  Over 80 percent of the cases are unilateral, and is more common in boys than in girls.
  • The ischemic necrosis of the femur head occurs at an early stage.  This is followed by new blood supply to the femoral head, resulting in new bone formations, usually lasting 1 to 2 years.  The final stage is a process of healing by new bone formations, which takes longer than 1 year to actually form.
  • The initial symptoms are pain in the groin, knee pain, and a limp.  The discomfort is relieved by rest, and gets worse with standing or gait.  Hip motion is restricted with pain.

  • Necrosis occurs as a result of local disturbances of the blood supply (ischemia) to the femur head.  It is unknown why this happens.

  • A hip X-Ray is normal in the early stages, but it shows the fragmentation and collapse of the femoral head as the disease progresses.
  • Bone scans

  • Treatment is aimed at the prevention of hip deformities
    1. Pain relief by anti-inflammatory medications and rest of the affected leg at an early stage.
    2. A brace is helpful to prevent deformities by containing the femur head in the acetabulum.  A brace must be worn for 1 to 2 years.

  • The prognosis depends on the age of patients, severity of necrosis and the treatment.  If the onset occurs earlier, or the necrosis is less severe, the prognosis is better.  If the femoral head is well contained in the acetabulum during the disease process, the outcome is favorable.  Deformity of the femoral head may result in the degenerative Osteoarthritis of the hip in later life.

more about Legg-Calve-Perthes' Disease

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