Perthes Disease

Perthes is a condition in children characterized by a temporary loss of blood supply to the hip. Without an adequate blood supply, the rounded head of the femur (the " ball " of the hip) dies. The area becomes intensely inflamed and irritated.

Perthes disease is usually seen in children between 4 to 10 years old. It is five times more common in boys than in girls.

Symptoms of Perthes Disease

  • Limping
  • Mild pain in parts of the leg, such as the groin, thigh, or knee
  • When the hip is moved, the pain worsens. Rest often relieves the pain.

The child may have had these symptoms intermittently over a period of weeks or even months. Pain sometimes is caused by muscle spasms that may result from irritation around the hip.

Perthes Disease Treatment

Treatment may require periods of immobilization or limitations on usual activities. The long-term prognosis is good in most cases. After 18 months to 2 years of treatment, most children return to normal activities without major limitations.

Non-Surgical Treatment of Perthes Disease

  • Anti-inflammatory medications
  • Physical therapy
  • Bed rest in traction may be needed in some cases

Surgical Treatment of Perthes Disease

Surgical treatment re-establishes the proper alignment of the bones of the hip. The head of the femur is placed deep within the socket, or acetabulum. This alignment is kept in place with screws and plates, which will be removed at a later time. In some cases, the socket must also be made deeper because the head of the femur has actually enlarged during the healing process and no longer fits snugly within. After either procedure, the child is often placed in a cast from the chest to the toes for 6 to 8 weeks.

After the cast is removed, the child will again participate in physical therapy. Activities will be designed so that the child only partially bears weight on the affected hip. X-rays will show when the final stages of the healing are under way.

Pediatric Orthopedics