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    Coxa Plana

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    Justin Ahorro-Dionisio
    1. Legg-Calve-Perthes disease, also known as Perthes disease, is a degenerative condition of the hip joint where loss of bone mass leads to collapse of the femoral head. 2. It most often affects Caucasian boys between the ages of 3 and 12, and is more common in males. The cause is unknown but involves reduced blood flow to the femoral head. 3. Symptoms may include knee or groin pain, limping, limited hip movement, and leg length differences. It is diagnosed through x-rays, bone scans, or MRIs.

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    Coxa Plana

    Uploaded by

    Justin Ahorro-Dionisio
    640 views13 pages
    1. Legg-Calve-Perthes disease, also known as Perthes disease, is a degenerative condition of the hip joint where loss of bone mass leads to collapse of the femoral head. 2. It most often affects Caucasian boys between the ages of 3 and 12, and is more common in males. The cause is unknown but involves reduced blood flow to the femoral head. 3. Symptoms may include knee or groin pain, limping, limited hip movement, and leg length differences. It is diagnosed through x-rays, bone scans, or MRIs.

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    1. Legg-Calve-Perthes disease, also known as Perthes disease, is a degenerative condition of the hip joint where loss of bone mass leads to collapse of the femoral head. 2. It most often affects Caucasian boys between the ages of 3 and 12, and is more common in males. The cause is unknown but involves reduced blood flow to the femoral head. 3. Symptoms may include knee or groin pain, limping, limited hip movement, and leg length differences. It is diagnosed through x-rays, bone scans, or MRIs.

    Copyright:

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    Download as PPT, PDF, TXT or read online from Scribd
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    640 views13 pages

    Coxa Plana

    Uploaded by

    Justin Ahorro-Dionisio
    1. Legg-Calve-Perthes disease, also known as Perthes disease, is a degenerative condition of the hip joint where loss of bone mass leads to collapse of the femoral head. 2. It most often affects Caucasian boys between the ages of 3 and 12, and is more common in males. The cause is unknown but involves reduced blood flow to the femoral head. 3. Symptoms may include knee or groin pain, limping, limited hip movement, and leg length differences. It is diagnosed through x-rays, bone scans, or MRIs.

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    m  

    Ú  
    
     m
    
      m
    
      
    
    Õ  m
     m  
    2 Legg-Calve-Perthes disease; Perthes disease
    2 Is a degenerative disease of the hip joint,
    where growth/loss of bone mass leads to some
    degree of collapse of the hip joint and to
    deformity of the ball of the femur and the
    surface of the hip socket. The disease is
    characterized by idiopathic avascular
    osteonecrosis of the capital femoral epiphysis
    of the femoral head leading to an interruption
    of the blood supply of the head of the femur
    close to the hip joint.
    Ú   

    2 accurs most frequently in boys 3 to 12


    years old.
    2 Caucasians are affected more frequently
    than other races
    2 Males are affected 3-
    3-4 times more often
    than females
    m 
    2 lthough no-
    no-one has identified the cause of
    Perthes disease it is known that there is a
    reduction in blood flow to the joint. It is thought
    that the artery of the ligamentum teres femoris
    closes too early, not allowing time for the
    medial circumflex femoral artery to take over.
    2 For example, a child may be 6 years old
    chronologically but may have grown to 4 years
    old in terms of bone maturity. The child may
    then engage in activity appropriate for a child
    of 6 but may not yet have the bone strength of
    an older child, leading to flattening or fracture
    of the hip joint.
    O 
    2 Gnee pain (may be the only symptom, initially)
    2 Persistent thigh or groin pain
    2 trophy (wasting) of muscles in the upper thigh
    2 Slight shortening of the leg, or legs of unequal
    length
    2 Hip stiffness restricting movement in the hip
    2 Difficulty walking, walking with a limp (which is
    often painless)
    2 Limited range of motion
    £    

    2 º-rays
    2 Bone scans
    2 Magnetic Resonance Imaging (MRI)
    2 rthrograms - a diagnostic imaging test to
    study the non-
    non-bony structures of joints.
    2 Blood tests
    2 Erythrocyte sedimentation rate - elevated if
    infection present
    
    
    2 The aim of treatment is to protect the bone and joint
    from further stress and injury while the healing process
    takes place.
    2 rest
    2 activity restrictions
    2 medications
    2 bed rest and traction
    2 casting or bracing (to hold the femoral head in the hip
    socket, permit limited joint movement, and allow the
    femur to remold itself into a round shape again)
    2 physical therapy (to keep the hip muscles strong and to
    promote hip movement)
    2 crutches or wheelchair (in some cases)
    O
    
    

    2 surgery (to hold the femoral head in the


    hip socket)
    2 Inominate osteotomy
    osteotomy;; varus osteotomy
    osteotomy;;
    osteotomy of the proximal femur,
    acetabulum (Salter innominate
    innominate), ), or a
    combination of these may be required
    2 ather than surgery; NSIDs such as
    Motrin help with the pain inflicted.
    ë ë
    ë 
    
    2 ë 
    2 
      - Blood supply is absent to the
    femoral head and the hip joint becomes
    inflamed, stiff, and painful. Portions of the bone
    turn into dead tissue. The ball of the thigh bone
    becomes less round in appearance on x- x-rays.
    This phase can last from several months up to
    one year.
    2 ë   
     - The body cleans up the
    dead bone cells and replaces them with new,
    healthier bone cells. The femoral head begins to
    remodel into a round shape again. The joint is still
    irritated and painful. This phase can last from one
    to three years.
    2 ë 
      
    
    
      
     - The femoral head
    continues to model itself back into a round shape
    with new bone. This phase lasts for one to three
    years.
    2 ë 
      - Normal bone cells replace
    the new bone cells and the remodeling continues.
    This last phase can last a few years to complete
    the healing process.
    m   

    2 asteoarthritis may develop later in life,


    although the development of
    osteoarthritis may be minimized with
    prompt recognition and proper treatment.
    
    

    2 The outcome is usually good with treatment.


    Most bone will heal with minimal lasting
    deformity.
    2 Children younger than 6 have the best
    prognosis since they have time for the dead
    bone to revascularize and remodel. Children
    that have been diagnosed with Perthes
    Perthes''
    Disease after the age of 10 are at a very high
    risk of developing osteoarthritis

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