Legg-Calvé-Perthes Disease

Legg-Calve,-Perthes disease is a self-limited disease of the femoral head that presents in the first decade. The pathogenesis is thought to involve bone necrosis, collapse, and repair. The presenting complaint is often a painless limp or hip pain, with decreased abduction and internal rotation of the hip. Factors that are believed to correlate with a poor prognosis are onset of symptoms after age 8 years, lateral head subluxation, involvement of over 50% of the femoral head with collapse of the lateral pillar, and the combination of an aspherical femoral head and an incongruent joint. The current cornerstones of treatment are maintenance of hip motion, relief of symptoms, and containment. Containment may be achieved by bracing or surgical means. The literature remains inconclusive on the indications for and effects of treatment. A long-term study has suggested that disabling arthritis of the hip develops in the sixth decade of life in 50% of untreated patients.