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Legg-Calvé-Perthes Disease

Avascular necrosis of the femoral head in children with a self-limiting course.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

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What is Legg-Calvé-Perthes Disease?

Legg-Calvé-Perthes disease (LCPD) is an avascular necrosis seen in children aged 4-8 due to a transient disruption of femoral head blood flow. The exact etiology is unknown, but vascular and mechanical factors are thought to play a role.

The disease passes through four stages: initial (synovitis), fragmentation (breakdown of necrotic bone), reossification (new bone formation), and healing (remodeling). The whole process can last 2-4 years and carries the risk of permanent femoral head deformity.

The Herring lateral pillar classification (A, B, B/C, C) and Catterall classification are used to determine the prognosis. The treatment goal is to maintain femoral head sphericity by 'containment' within the acetabulum.

Symptoms

Painless or mildly painful limping
Groin, thigh, and knee pain
Restricted hip motion (especially abduction and internal rotation)
Trendelenburg gait
Limb shortening (in advanced stage)
Quadriceps atrophy

Risk Factors

Male sex (4-5 times more frequent)
Age 4-8 years (peak 5-7 years)
Low birth weight
Passive smoke exposure
History of trauma
Coagulopathy and clotting disorders

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Painless limping in a child aged 3-10 years
  • Persistent knee or groin pain in a child
  • Bilateral hip pain
  • Suspected femoral head deformation after treatment
  • Persistent restricted hip motion in a child

Treatment Methods

01
Activity restriction and NSAIDs in early stage
02
Physical therapy to preserve range of motion
03
Abduction brace (Petrie cast, Atlanta brace)
04
Conservative containment treatment
05
Femoral varus osteotomy (surgical containment)
06
Pelvic osteotomy (Salter, Chiari)
07
Comprehensive surgery in older age and severe deformity
08
Long-term orthopedic follow-up (until skeletal maturity)

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.