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    Legg Calve Perthes

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    Adrian Mallar
    Legg Calve Perthes (LCPD) is a degenerative disease of the hip joint typically found in young children where loss of blood supply to the femoral head leads to bone death and deformity of the hip ball and socket. Symptoms include limping, hip or groin pain exacerbated by movement, and leg length inequality. The disease progresses through four stages and treatment aims to reduce pain and hip irritability while preventing femoral head collapse and maintaining mobility. This can involve medical management, surgery such as osteotomies, or nonsurgical treatments like casting and bracing.

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    Legg Calve Perthes

    Uploaded by

    Adrian Mallar
    589 views7 pages
    Legg Calve Perthes (LCPD) is a degenerative disease of the hip joint typically found in young children where loss of blood supply to the femoral head leads to bone death and deformity of the hip ball and socket. Symptoms include limping, hip or groin pain exacerbated by movement, and leg length inequality. The disease progresses through four stages and treatment aims to reduce pain and hip irritability while preventing femoral head collapse and maintaining mobility. This can involve medical management, surgery such as osteotomies, or nonsurgical treatments like casting and bracing.

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    Legg Calve Perthes (LCPD) is a degenerative disease of the hip joint typically found in young children where loss of blood supply to the femoral head leads to bone death and deformity of the hip ball and socket. Symptoms include limping, hip or groin pain exacerbated by movement, and leg length inequality. The disease progresses through four stages and treatment aims to reduce pain and hip irritability while preventing femoral head collapse and maintaining mobility. This can involve medical management, surgery such as osteotomies, or nonsurgical treatments like casting and bracing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    589 views7 pages

    Legg Calve Perthes

    Uploaded by

    Adrian Mallar
    Legg Calve Perthes (LCPD) is a degenerative disease of the hip joint typically found in young children where loss of blood supply to the femoral head leads to bone death and deformity of the hip ball and socket. Symptoms include limping, hip or groin pain exacerbated by movement, and leg length inequality. The disease progresses through four stages and treatment aims to reduce pain and hip irritability while preventing femoral head collapse and maintaining mobility. This can involve medical management, surgery such as osteotomies, or nonsurgical treatments like casting and bracing.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 7

    Legg Calve Perthes (LCPD)

    Is a degenerative disease of the hip joint, where growth/loss


    of bone mass leads to some degree of collapse of the hip joint and
    to deformity of the ball of the femur and the surface of the hip
    socket. The disease is characterized by idiopathic avascular
    osteonecrosis of the capital femoral epiphysis of the femoral head
    leading to an interruption of the blood supply of the head of the
    femur close to the hip joint. The disease is typically found in young
    children, and it can lead to osteoarthritis in adults. The effects of
    the disease can sometimes continue into adulthood.
    Also known as:
    Perthes disease
    Ischemic necrosis of the hip
    o!a plana
    "steochondritis
    #ascular necrosis of the femoral head
    Causes$
    The e!act cause is unknown
    %eduction in blood flow to the joint
    It is thought that the artery of the ligamentum teres femoris
    closes too early, not allowing time for the medical circumfle!
    femoral artery to take over
    &bnormal blood clotting
    Infection
    'alnourishment
    (enetic
    Trauma
    Incidence
    Perthes is rare, occurring in appro!imately ).) of *++,+++ children.
    Signs & Symtoms$
    ,irst -igns$
    complaint of sourness from the child .often dismissed
    as growing pain/
    limping
    guarding of the joint
    "ther -ymptoms$
    hip, knee .reffered pain/, or groin pain, e!acerbated
    by hip/leg movement.
    %educe %"' at the hip joint and a painful or antalgic
    gait
    &trophy of thigh muscles from disuse
    Ine0uality of the leg length.
    Pathohysiology
    Predisposing/ %isk factors$
    "besity
    ,amily history
    1ow birth weight
    &bnormal presentation at birth
    %ace2 &sians, 3skimos, whites
    (enetic, Infection, Trauma, 'alnutrition, &bnormal 4lood lotting,
    Idiopathic.
    %apid (rowth 5 6evelopment of the -upply of the -econdary "ssification
    enters in the 3piphysis.
    Interrupted of ade0uate blood flow
    Prone to avascular necrosis
    %esult in necrosis
    6eformity of the ball of the hip, knee or groin
    pain
    femur and the surface of the
    hip socket
    1imping, guarding of
    the joint
    ine0uality of leg length
    antalgic gait
    6isuse
    &trophy thigh muscles
    !our Stages o" LCPD
    1. ,emoral head becomes more dense with possible fracture
    of supporting bone7
    2. ,ragmentation and reabsorption of bone7
    3. %eossification when new bone has regrown7 and
    4. 8ealing, when new bone reshapes.
    Phase I takes about 92: months, Phase : takes one year or
    more, and Phase ; and < may go on for many years.
    Diagnosis:
    =2%ay
    'agnetic %esonance Imaging .'%I/
    bone scan
    #reatment
    The goal of treatment is four2fold$
    I/ to reduce hip irritability
    :/ restore and maintain hip mobility
    ;/ to prevent the ball from e!truding or collapsing
    </ to regain a spherical femoral head
    $edical $%#$
    >-&I6 .'otrin) ? for pain
    @oledponic &cid .under investigation/
    Surgical $%#:
    -urgery is indicated for children greater that age 9 years.
    3!cision of e!truded portion of the head for hinge abduction
    &cetabular osteotomy
    1ateral shelf osteotomy
    hiari osteotomy
    #algus osteotomy
    &rthrodesis
    &on'surgical treatment:
    cast
    traction
    braces
    Prevention
    There is no known effective preventative measure
    &ursing $%#:
    6istraction method ? for pain
    &dvice refrains from contacts sports or game/activities which
    impact the pain.
    %eneral Interventions:
    1. Instruct patient to report pain as soon as it begins
    2. Provide 0uite environment, calm activities.
    3. 3ncourage use of diversional activity .T#, %adio,
    socializing/
    4. 3ncourage ade0uate rest periods to prevent fatigue
    evaluate in pain behavior
    &ursing D(:
    &cute pain related to inflammation of joint secondary to legg
    calve perthes disease.
    Impaired physical mobility related to abnormal gait secondary
    to legg calve perthes disease.
    %isk for injury related to altered mobility secondary to
    unsteady gait.
    Avascular &ecrosis
    Is a disease resulting from the temporary or permanent loss
    of the blood supply to the bone. Aithout blood, the bone tissue dies
    and causes the bone to collapse. If the process involves the bones
    near a joint, it often leads to collapse of the joint surface.
    Also known as:
    "steonecrosis
    &septic necrosis
    Ischemic bone necrosis
    )tiologies$
    &lcohol abuse
    aisson .decompression/ disease
    igarette smoking
    ,at emboli
    (out
    %adiation therapy
    %aynauld phenomenon
    -ickle cell disease with increase blood viscosity
    -ystemic steroids
    Trauma, such as fracture, disruption circulation in the bone
    Bnknown cause, known as idiopathic &#>
    Causes$
    ,ollowing is a list of causes or underlying conditions .see also
    'isdiagnosis of underlying causes of &vascular necrosis/ that could
    possibly cause &vascular necrosis includes$
    Traumatic injury
    ,racture
    6islocation
    6islocated hip .see 8ip symptoms/
    &lcoholism
    3!cessive alcohol
    Pathohysiology
    %isk factors$
    injury
    steroid use
    (aucher disease
    alcohol use
    blood disorders, such as sickle cell anemia
    radiation treatments
    chemotherapy
    pancreatitis
    decompression disease
    Traumatic causes non2traumatic causes
    Temporary or permanent loss of blood supply to the bone
    Ahen blood supply is cut off, the bone tissue dies
    minimal early joint pain
    4one collapses
    increased joint pain as bone and joint begin to collapse
    If it occurs near a joint, collapse of the joint surface may occur
    limited range of motion due to pain
    Diagnostic #ests
    The list of diagnostic tests mentioned in various sources as used
    in the diagnosis of &vascular necrosis includes$
    =2rays
    '%I 2 good for diagnosis in the early stages
    4one scintigraphy .bone scan/
    T scan
    4one biopsy
    #reatments "or Avascular necrosis
    The list of treatments mentioned in various sources for &vascular
    necrosis includes the following list. &lways seek professional medical
    advice about any treatment or change in treatment plans.
    >-&I6s 2 for pain
    &void weight bearing 2 take pressure off the joint .e.g.
    crutches/7 in some cases this allows the body to self2heal.
    %ange2of2motion e!ercises
    3lectrical stimulation 2 to stimulate natural growth of the
    bone.
    &void alcohol
    Treat alcoholism 2 if the problem is caused by alcoholism.
    6iscontinue corticosteroid use 2 slowly under medical advice,
    since stopping 0uickly causes problems.
    -urgical treatments
    o ore decompression
    o "steotomy
    o 4one graft
    o Coint replacement .arthroplasty/
    &ursing D(:
    Impair physical mobility related to &#> of femoral head or
    tarsal navicular bone.
    &cute pain related to ischemic changes and degeneration of
    involved bone.

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