Although the cause of the M. Perthes is not known, seem to bone infarcts (Knochentod) in certain areas of the Hüftkopfes to play a role. It seems to plant-related factors for M. Perthes to give. Often children are affected by a slow bone development, bone age is usually retarded.
At the age of the 6th Year of life seems to be the vascular supply of the verknöchernden Hüftkopfes to be critical.
What are the future prospects for M. Perthes (Hüftkopfnekrose of the child)?
The M. Perthes disease typically proceeds in stages. The young child in the presence of the orthopedic disease, the better the prognosis. Crucial to the long-term trend is the shape of the hip joint components (deformity) after the end of the reconstruction.
What complaints can be obtained from the M. Perthes child gets sick?
Among the early signs of Perthes disease include stress-related hip pain, the child is often in the knee joint but can be specified. Through this incident, the causes of the complaints are often detected only delayed. Schonhinken, running and easy fatigability Laziness is often observed by the parents. In the course of Perthes disease, it can cause permanent leg shortening, because of the significantly changed Hüftkopf developed.
What are the indications for M. Perthes (Hüftkopfnekrose of the child), there is the investigation?
- Gait change with Schonhinken
- Muscular atrophy of the hip joint, surrounding muscles.
- Bar pressure pain
- Pelvic misalignment with leg length difference)
- Frequently, a different joints in the hip joint can be identified.
- Movement pain especially when Einwärtsdrehen and Abspreizen.
How can the diagnosis of M. Perthes backed up?
The X-ray in 2 planes of the hip (pelvis ap and Lauenstein) is to ensure the diagnosis and course observation is necessary.
In some cases, further investigations apparative useful. Ultrasound examination and Kernspintomografische have partially completed.
What are the objectives in the treatment of Perthes M. prosecuted?
The treatment of Perthes M. (Hüftkopfnekrose of the child) is aimed at the healing of bone destruction. The remainder of the growth and shape change change be as small as possible. By remaining Fehlform of the hip joint can be a cartilage injury during a Hiparthritis (Coxarthrose) train.
There are two opposing philosophies in the treatment of M. Perthes hips.
- Relief measures of the hip joint (non-containment method)
- Measures to improve the roofing of the affected Hüftkopfes (containment methods)
Different clinical and radiographic signs require a flexible application of treatment principles.
The therapy targets a painless, mobile and well-functioning hip during Perthes disease. At the end of the Hüfterkrankung is a well-molded hip arise.
What should the parents and the affected child adjust?
The disease may be deferred until the completion of growth thereafter. Need regular checks of both hip function and the radiological changes of the hip joint.
Gentle joint sports like swimming and horseback riding are available without restriction.
Subsequent treatments are possible and necessary:
- drug therapy with painkillers
- Physical training with the buttocks muscles, gait school, exercise, and particularly Interior Abspreizübungen rotation.
- Conservation and pollution reduction avoid heavy load. Bed rest in the painful stage of M. Perthes.
- Orthesenversorgung to discharge or additional abduction of the hip joint
When is a hip replacement in the treatment of Hüftkopfnekrose of the child necessary?
Operation indication arises mainly from incomplete containment.
The younger the patient and the lower the Catterall group, the more cautious should the indication for surgery asked. Here are the thigh and hip differed.
Synonyms:
M. Legg-Perthes-Calvé-Waldenström, juvenile Hüftkopfnekrose
Perthes disease, juvenile Hüftkopfnekrose, Perthes'disease, Aseptic Knochennekrose of the child's Hüftkopfes
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