Legg calve perthes (1597)

What is Legg-Calve’ Perthes?

Legg-Calve’ Perthes is a condition that affects the upper part of the large bone in the thigh (femur). The femur loses its blood supply for a period of time. This causes damage to the hip joint. This
problem is called avascular necrosis. Normally only one hip joint is affected. It often occurs in children ages 2 to 12 years and is more common in boys.

What causes it?

The cause is not known. It is more common in families where other family members have also had the condition (genetic).

How does it affect my child?

Perthes normally has several stages. The stages happen over a period of months to years. The stages may not follow in order, and parts of each stage may happen at the same time.

Initial stage

• 2 to 3 months
• Blood supply is lost
• Hip pain and limited motion
• X-rays still look normal

Healing stage

• 9 to 12 months
• Condition progressing
• Hip bone is soft and loses shape easily
• Pain in the hip
• Condition is often diagnosed in this stage
• Bone begins to heal and normal strength of joint returns later in this stage

Healed stage

• The joint is healed
• Bones may be able to remodel or return
• The younger the child, the better the chance for remodeling

What tests will be done?

X-rays are done to see what stage the condition is in. A bone scan may be done if needed. These tests also show how the joint has been affected. Other tests may also be done to look at the structure of the bone. After the tests are done, treatment will be started.

How is it treated?

Treatment is done to help reduce damage to the hip joint. Without treatment, your child has a greater risk of having hip arthritis. This could affect movement and cause pain.

Possible treatments include:

• Traction of the leg(s). This is used to improve the motion of the hip. Your child would need to be in the hospital to have traction done.
• Braces or casts. A brace or long leg casts may be needed for a period of time. Braces or a cast help keep the ball of the thighbone in the hip socket and keeps the hip muscles stretched.
• Hip surgery. A small number of children with severe hip joint problems will need surgery. Screws and/or plates are used to hold the bones in place in the socket. They stay in place until
  the condition has run its course. After surgery, a brace is worn for about 8 weeks or until the hip is healed. After the brace is taken off, your child can go back to normal activities.

What follow-up care is needed?

• Your child will need ongoing medical care, x-rays and checkups until reaching maturity. This is about age 14 in girls or age 16 in boys. If surgery is done, the screws and/or plates will be
  removed after about 12 months. Your child will have a short hospital stay when the screws/plates are removed.
• For about 8 weeks after the hardware is removed, your child should not run or jump.
• When treatment and healing are complete, the affected leg may be a little shorter than the other leg. This problem may correct itself. Some children, however, may need surgery on the
  unaffected leg to slow its growth. This will allow the shorter leg to catch up.

For more health and wellness information, check out this resource:

https://kidshealth.org/ChildrensWi/en/parents

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.