Perthes disease, which is mostly seen in boys, usually occurs with complaints such as limping and limping. The earlier Perthes disease, which is usually seen between the ages of 4 and 10, is diagnosed, the more successful the treatment.
What is Perthes Disease?
Perthes disease is one of the important diseases of pediatric orthopedics. Perthes Disease develops with a temporary pause in the blood flow of the ball-shaped bone region at the top of the thigh, which we call the femoral head. As a result, Perthes disease progresses in a process of bone death, which we call necrosis in the femoral head, and then the necrotic bone is removed and new bone formation. It is a common disease in children aged 4-10 years. Perthes disease is four times more common in boys than girls. Children with Perthes disease are generally very active and have a structure that we call intangible.
What are the Symptoms of Perthes Disease?
Perthes patients often complain of limp, hip and/or knee pain. They apply to the Pediatric Orthopedist. The symptoms of the patients sometimes intensify, from time to time they are relieved. In the examinations of Perthes patients, joint movements are limited and the child may complain of pain during joint movements. In advanced cases, thinning and shortness of the leg diameter can be seen.
How to Diagnose in Perthes Disease?
In Perthes disease, the diagnosis is made by anamnesis, physical examination and radiography. In the majority of cases in the diagnosis of Perthes disease, MRI or tomography is not needed. On the other hand, MRI can provide diagnosis in the early stages of the disease. MRI examination may be needed if the radiological findings are normal and the disruption does not go away within 1 week – 10 days.
Early diagnosis is very important in the treatment of Perthes disease!
What to Do in the Treatment of Perthes Disease?
In Perthes disease, necrosis of some or all of the femoral head bone is caused by impaired nutrition of the femoral head. bone death occurs. This necrotic bone is absorbed by the body. k (by elimination), new bone formation is achieved. Since the bone is softer and weaker in this reconstruction process, fractures and collapses of the skull can be seen in traumas such as jumping, jumping and falling. During restructuring, the femoral head takes shape according to the pressure it receives. For this reason, it is aimed to keep the femoral head in the socket part of the hip joint, which we call the acetabulum, in the treatment. In this way, it is aimed to develop in a global structure.
The main goal in the treatment of Perthes disease is to preserve the range of motion of the joint so that the head can develop in a spherical structure. Especially during painful periods, rest and treatment with anti-inflammatory drugs are recommended. The process of Perthes disease lasts for 2-2.5 years. In this process, the child should be prevented as much as possible from engaging in extreme sports activities, jumping from a height and participating in contact sports. However, the child's daily activities are not restricted.
To keep the ball of the femoral head in the socket, the application of plaster with the legs in the open position, the use of some orthoses and surgical applications are the methods used by Pediatric Orthopedists. The long course of the disease (2-2.5 years) makes it difficult for children to adapt to plaster or orthosis treatment. For this reason, many orthopedists turn to surgical treatment in necessary cases. The main purpose of surgery is to ensure that the femoral head is placed in the acetabulum socket in order to ensure its development in a spherical structure.
How does Perthes Disease progress?
The clinical course of Perthes disease depends on the age of the patient and the amount of involvement. As a general rule, the course of Perthes disease is quite good under the age of 6 years. In patients older than 8 years, the course of the disease is more severe. While a significant portion of the patients recover without sequelae, a small number of patients have shortness, limping, and femoral head deformity.
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