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Legg-Calve-Perthes

Disease
WaferAldulaimi / Denmark
The diseaswasdiscovered in 1910
shortlyafterdevelopment of x-ray
Epidemiology
 1/1200 /year

 usuallyhappens in youngboys 5-7 yearsold

(3-12) thataresmaller in stature and
thattend to ...
Alsoseen in small activedogs
Pathoanatomy
Transient avascularnecrosis of femoral
head
Symptoms and signs
 Limping
 Pain in hip, groin or sometimes knee area
 Stiffness
 Decrease range of motion in hip
 L...
Diagnosis
 History , physical examination and plane x-

rays

 MR scanning not routinely
Stages
1. Necrosis : Femoral head appears smaller
on x-rays
2. Fragmentation and femoral head
collapse. (The pain and limp...
Treatment
Main goal is the keep the femoral head
inside the socket of the hip
1. Symptomatic treatment and
physiotherapy
2...
 Femoral varusosteotomy
 Pelvicosteotomy
 Combinedosteotomy
In case of Hinge abduction (lateral extrusion of the
femoral head resulting in the femoral head
impinging on the edge of t...
An abduction-extension proximal femoral
osteotomy should be considered
 Most patients with LCPD do well until the fifth

or sixth decade of life, at which time
degenerative changes in the hip ...
CLPD
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CLPD

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Calve Legg Perthes disease

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CLPD

  1. 1. Legg-Calve-Perthes Disease WaferAldulaimi / Denmark
  2. 2. The diseaswasdiscovered in 1910 shortlyafterdevelopment of x-ray
  3. 3. Epidemiology  1/1200 /year  usuallyhappens in youngboys 5-7 yearsold (3-12) thataresmaller in stature and thattend to beveryactive
  4. 4. Alsoseen in small activedogs
  5. 5. Pathoanatomy Transient avascularnecrosis of femoral head
  6. 6. Symptoms and signs  Limping  Pain in hip, groin or sometimes knee area  Stiffness  Decrease range of motion in hip  Leg length differentiation  Pain can vary depending on child, amount of physical activity and how long child goes without seeking professional help  some muscle spasms
  7. 7. Diagnosis  History , physical examination and plane x- rays  MR scanning not routinely
  8. 8. Stages 1. Necrosis : Femoral head appears smaller on x-rays 2. Fragmentation and femoral head collapse. (The pain and limp are worse during this stage) 3. Reossifiction: Healing phase starts when new bone formation begins. (The pain decreases) 4. Remodeling :The head is completely healed and the dead bone is now replaced with new bone
  9. 9. Treatment Main goal is the keep the femoral head inside the socket of the hip 1. Symptomatic treatment and physiotherapy 2. Follow up: Pain and limp. Range of movement and x-rays 3. Containment by braces or casting ( No longer advocated ! ) 4. Containment by surgery
  10. 10.  Femoral varusosteotomy
  11. 11.  Pelvicosteotomy
  12. 12.  Combinedosteotomy
  13. 13. In case of Hinge abduction (lateral extrusion of the femoral head resulting in the femoral head impinging on the edge of the acetabulum with abduction)
  14. 14. An abduction-extension proximal femoral osteotomy should be considered
  15. 15.  Most patients with LCPD do well until the fifth or sixth decade of life, at which time degenerative changes in the hip joint are common which may need THA

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