7336 - Legg Calve Perthes

Test and Measures

- limp common due to leg length discrepancy - trendelenburg common Tests: - Bot2 (4-21), Peabody (0-5)for gross motor measure - PBS - Pediatric Balance Scale

S/S

-Limping. -Pain or stiffness in the hip, groin, thigh or knee. -Limited range of motion of the hip joint.

Long Term Implications

Children who have had Legg-Calve-Perthes disease are at higher risk of developing hip arthritis in adulthood — particularly if the hip joint heals in an abnormal shape. If the hip bones don't fit together well after healing, this can cause the joint to wear out early. Hip replacement surgery eventually may be required. In general, children who are diagnosed with Legg-Calve-Perthes after age 6 are more likely to develop hip problems later in life. The younger the child is, the better the chances for the hip joint healing in a normal, round shape.

Legg Calve Perthes - Facts

Femoral head becomes nectrotic due to poor blood supply - can affect hip joint - femoral head collapses leading to arthritis/deformity - gets worse over time w more weight bearing - Age 4-8 Legg-Calvé-Perthes disease (LCPD) is a childhood hip disorder initiated by a disruption of blood flow to the ball of the femur called the femoral head. Due to the lack of blood flow, the bone dies (osteonecrosis or avascular necrosis) and stops growing.

Etiology

Idiopathic - due to vascular issue? - from hip dislocation?

Stages of Healing

Stage 1 - bone becomes weaker - more suspecitble to fx Stage 2 - Fragmentation: acetabulum bc unstable. Lasts several mths-->1yr. Stage 3 - Healing phase: Femoral bone growth surpasses reabsorption. Lasts 3-5 yrs Stage 4-Remodeling phase: finished when reach skeletal maturity. Femoral head may flatten or normalize