Orthopedics Book

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Legg-Calve-PerthesAka: Aseptic Necrosis of the Femoral Head

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  1. See Also
    1. Pediatric Limp
  2. Epidemiology
    1. Children age <10 years
    2. Boys affected 4-5 times more often than girls
    3. Familial in 20% of cases
    4. Incidence 1:1000 to 1:5000
  3. Pathophysiology
    1. Juvenile idiopathic avascular necrosis of femoral head
  4. Etiology
    1. Idiopathic
  5. Symptoms
    1. Pain in area of hip or referred to knee
  6. Signs
    1. Child walks with a limp
    2. Decreased hip range of motion
  7. Management
    1. Difficult management
      1. Long-term treatment
      2. Limited activity
    2. Bracing and casting for up to 1-2 years
    3. Surgery will allow child back to activity in 4-6 months
  8. Complications
    1. Severe degenerative hip disease
      1. Requires hip replacement by middle age in 50% cases
  9. Prognosis
    1. Fair at best (see complications above)

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