Perthes Disease Current Principles of Diagnosis and Treatment

被引:39
作者
Nelitz, Manfred [1 ]
Lippacher, Sabine [1 ]
Krauspe, Ruediger [1 ]
Reichel, Heiko [1 ]
机构
[1] Orthopad Univ Klin Ulm RKU, D-89081 Ulm, Germany
来源
DEUTSCHES ARZTEBLATT INTERNATIONAL | 2009年 / 106卷 / 31-32期
关键词
Legg-Calve-Perthes disease; pediatric disease; prognosis; osteochondrosis; joint diagnosis; FOLLOW-UP; CATTERALL CLASSIFICATION; HINGE ABDUCTION; LATERAL PILLAR; CHILDREN; PROGNOSIS; OSTEOTOMY; RELIABILITY; MATURITY; AGE;
D O I
10.3238/arztebl.2009.0517
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Because the course of Legg-Calve-Perthes disease (LCPD) is highly variable, its appropriate diagnostic evaluation and treatment are still debated. Methods: The authors selectively review the literature, present their own study findings, and discuss the guidelines of the German Society for Orthopedics and Orthopedic Surgery. Results: The main prognostic factors are the patient's age at the onset of the disease, the degree of limitation of range of motion, the extent of involvement of the femoral epiphysis, and any additional radiographic "head-at-risk" signs. Depending on the severity of the disease, the treatment options range from observation and frequent follow-up to reconstructive hip surgery. The goal of all treatments is to prevent a prearthrotic deformity and the ensuing premature coxarthrosis. This goal is best met by adherence to the principle of containment, i.e., the maintenance or restoration of joint congruence while biological plasticity is still present. Conclusions: In view of the variable course of LCPD, the proper course of treatment must be determined individually in each case. Every child with LCPD must receive individually adapted treatment and continued follow-up into adulthood.
引用
收藏
页码:517 / U21
页数:8
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