Early natural history of untreated Perthes' disease

Thirty patients with Legg-Calve'-Perthes' Disease (LCPD) presenting in Gwynedd, North Wales over a ten year period were reviewed with the aim of determining retrospectively the short-term clinical and anatomical outcome of the untreated condition. They were all allowed unrestricted activity irrespective of their radiological appearances. The mode of presentation, activity levels, analgesic requirements and physical signs during the active phase and at the final review were assessed. The clinical end-result assessment was based on a modification of the Harris hip assessment system. The radiological end-result was based on the Stulberg-End-Result Classification. The clinical results were satisfactory, with only 3.3 pc poor results; 23.3 pc fair and 73.3 pc good. The radiological results were 10 pc poor; 30 fair and 60 pc good. It is concluded that the short-term outcome of untreated LCPD is satisfactory in the majority of patients.