Perthes Disease

Perthes Disease

What is Perthes disease?

Perthes disease is caused by a pathological condition in the hip. It happens when a bone loses its vitality due to poor nourishment. It can affect a portion of the thigh bone's head or, in rare cases, the complete thigh bone. While the body regenerates this area that has lost its vitality, the bone that is being built is softer and less durable, so it cannot withstand the movements of daily life and breaks.The fracture causes the femoral head to collapse and deform. Due to the location of the ossification nucleus, which is responsible for bone growth, at the head of the thigh, a lack of blood flow to this area results in stunted growth and shortening of the leg where the head of the thigh is malformed.

Perthes disease is one of the most common pediatric painful illnesses. Although it is seen in children aged 2 to 12, the most prevalent age range for this condition is 4 to 9 years. Boys have a higher incidence rate than girls. Later in life, the illness affects the second hip in 10% of children.

Causes of Perthes' disease?

Despite numerous possibilities, the origin of the disease has yet to be determined. Protein C and S deficiencies, which are involved in the blood clotting process, have been blamed, as has the simple formation of intravascular clotting (thrombophilia) and difficult dissolution of the formed clot (hypofibrinolysis) as a result of protein C resistance. The frequent occurrence of femoral head avascular necrosis in various blood disorders with impaired blood fluidity (thalassemia major, sickle cell anemia) has prompted researchers to consider this possibility.

It has been proposed that variations in the vessels supplying the femoral head jeopardize the femoral head's blood supply. This supports the hypothesis that trauma is the primary cause of the disease.

It has also been proposed that obstructed venous drainage of the femoral head and neck raises intra-osseous pressure, resulting in avascular necrosis. Although attempts have been made to establish a link between the synovitis period at the outset of the disease and transitory synovitis, the altered blood dynamics in the femoral head recover in almost all individuals with transient synovitis.

The disease is caused by a decrease in blood flow to the hip joint during development (the hip joint is formed by the femoral head and the hip bone). Perthes' disease affects boys more frequently than girls. It affects 1 in 1000 boys and 1 in 4500 girls. Perthes' disease affects both hips in 10% of cases. The sickness fluctuates, with brief periods of recovery. is highly susceptible to the sickness.

What are the symptoms of Perthes disease?

Perthes' disease is characterized by symptoms such as thigh and buttock soreness, limping, and limping. These symptoms might be extremely mild or very severe at times. Leg shortening has been observed in very uncommon occurrences. As a result, it is important to visit a pediatric orthopedic specialist as soon as possible if a child complains of pain and walks with a limp.

- Knee pain

- Pain and limitation in hip movements

- Limping

- Muscle weakness in those with long-term complaints

Perthes Disease treatment

Perthes disease requires constant and careful medical follow-up from birth to adulthood and old age, according to the medical literature. The majority of Perthes patients come to us with problems like limping, limping, hip and knee discomfort, and so on. Perthes disease can be diagnosed using anamnesis, physical examination, and radiography. To confirm the diagnosis, an MRI and tomography may be required.The main goal in the treatment of Perthes' disease is to maintain range of motion. With the treatment applied, the femoral head is kept inside the hip joint socket called the acetabulum. In this way, the development of the joint in a spherical structure is aimed. Joint range of motion is preserved so that the femoral head can develop in a spherical structure."

Perthes' disease lasts about 2 to 2.5 years, and the patient should avoid strenuous physical activity, such as jumping from great heights and participating in contact sports, during this time. Aside from these restrictions, the patient's daily activities are unrestricted. During uncomfortable periods, anti-inflammatory medication and rest are recommended in addition to the precautions taken against activities. In order to keep the ball of the femoral head in the socket, plaster cast application with the legs in the open position, the use of some orthoses and surgical applications can be included in the treatment process. However, depending on the long course of the disease, plaster and orthosis treatment may make it difficult for children to adapt. Accordingly, surgical intervention is generally preferred. In the surgical intervention, the femoral head is placed into the acetabulum socket to ensure its spherical development.