Loss of blood to the growth plate in the head of the femur (thigh bone) leads to a problem called Legg-Calvé-Perthes disease. Children between the ages of four and eight are affected most often. The condition can occur earlier or later as well.
In this article, Legg-Calvé-Perthes disease is reviewed. The name of the condition, who is affected, and how it develops are included. How it first appears, the diagnosis, and treatment are discussed. Drawings and X-rays are provided to show the classification scheme (Class I through V). Classification is used to describe severity of the deformity that can develop.
The disease was first identified by three doctors in three separate countries. Using X-rays for the first time in the early 1900s, Dr. Legg in the United States, Dr. Calvé in France, and Dr. Perthes in Germany all independently described this problem.
Treatment is focused on keeping the femoral head smooth and spherical (round-shaped). Preventing pain, loss of motion, and later, arthritis are the goals of management. Understanding the natural history of a condition gives doctors a chance to change what happens.
Natural history refers to what happens from start to finish. The true course of this disease is only known when a child does not receive the treatment he or she needs.
Most studies report on symptoms and hip structure after treatment that may include traction, physical therapy, medications, casting, bracing, or surgery. The natural history is altered on purpose by treatment.
Research shows that the disease lasts longer when it’s more severe. In other words, milder cases heal much faster than severe cases. As might be expected, the more deformity and collapse of the hip, the worse the results.
Younger patients get better faster with fewer problems. Children over the age of 10 when the disease is diagnosed have the most permanent deformity. Arthritis and hip replacement are common in adults who once had Legg-Calvé-Perthes as a child.
Ongoing research is needed to find the best treatment for each child. Altering the natural history and preventing long-term problems in adulthood is an important goal.