What is the difference between Perthes' disease in children?

Perthes disease in children implies a disease under which a temporary violation of blood supply in the femur is observed . Already after, in the absence of proper blood flow, the tissues of the femoral head (spongy and cartilaginous) are destroyed. According to experts, Perthes' disease in children occurs between the ages of four and about 10 years. It is noteworthy that this malady in boys is diagnosed approximately five times more often, according to available data.

Perthes disease. Causes

Unfortunately, at present, the true factors leading to the development of this disease are not known. Some doctors say that the common cause is frequent colds and injuries. There is also information that the cause lies in an innate dislocation, however, according to available data, this case is possible only one in a million.

Symptoms

Most often, young patients begin to complain of pain in the hip joint itself. Note that the discomfort is manifested with a relatively small periodicity. So the intervals can be from a few days to a couple of months. Perthes disease in children can manifest itself in the form of pain in other parts of the body, namely in the groin and gluteal regions. When driving, it often intensifies.

Diagnostics

Perthes disease in children can be determined exclusively by a qualified specialist after a series of additional tests. For example, a small patient is assigned a radiograph of the hip joint itself. Already during the planned treatment, after confirmation of the diagnosis, it may take several more shots to determine the full picture of the disease.

Perthes disease. Stages of

At the moment, doctors allocate conditionally four stages of this ailment:

• 1st stage. In this case, the patient does not yet know about his disease. Such a change in bone structure at the microscopic level is almost impossible to determine by the basic methods of diagnosis. Consistently develops the so-called subchondral osteonecrosis.
• The 2 nd stage. There is a feeling of discomfort, as well as minor pain in the zone of the hip joint. Then there is an impression fracture. The area of available structural changes, according to experts, varies from 10 to 30%.
• 3rd stage. The patient begins to complain of pain during movement, which does not pass at rest. This stage of the development of the disease, as a rule, is determined by the unevenness of the outline of the head of the femur. The articular space expands or, on the contrary, narrows.
• 4th stage. The joint is practically devoid of its functionality, constant pains are felt. The head at this stage is completely destroyed, there is a dislocation or even a subluxation. In this case, the area of structural changes is determined by the boundaries from 50 to 80%.

Treatment

If the roentgenogram showed insignificant signs of the disease, only constant monitoring of the child is prescribed. Otherwise, with obvious symptoms of the disease, some therapies are used.

Non-surgical treatment

To reduce discomfort and pain directly in the hip joint, children are prescribed non-steroidal anti-inflammatory drugs (for example, "Ibuprofen"). The scheme of treatment in this case depends directly on the intensity of tissue repair. In addition, a special course of physical therapy is prescribed, the exercises of which are recommended to be performed until complete cure. With progressive deformity, a plaster bandage is prescribed, which allows to hold the head of the femur inside the so-called acetabulum.

Surgery

The operation allows you to completely restore the necessary location of all bones directly in the hip joint. So, in this case, the head of the bone moves inside the aforementioned acetabulum. This position is fixed by means of special bolts and plates, which are completely removed after a certain period of time. The process of rehabilitation here depends on the success of the operation itself.