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Children with acute Perthes' disease have asymmetrical lower leg growth and abnormal collagen turnover

Patricia M Crofton1, Catherine Macfarlane, Barbara Wardhaugh

  • 1Department of Paediatric Biochemistry, Royal Hospital for Sick Children, Edinburgh, UK. patricia.crofton@luht.scot.nhs.uk

Acta Orthopaedica
|February 14, 2006
PubMed

Insights

Children with Perthes' disease show impaired growth and collagen turnover, with low insulin-like growth factor-I (IGF-I) potentially affecting soft tissue synthesis and growth during the acute phase.

Area of Science:

  • Pediatric Orthopedics
  • Endocrinology
  • Biochemistry

Background:

  • Perthes' disease is associated with growth abnormalities and low insulin-like growth factor-I (IGF-I).
  • The acute phase of Perthes' disease may involve disruptions in growth, bone, and collagen turnover.

Purpose of the Study:

  • To investigate growth abnormalities, bone turnover, and collagen turnover during the acute phase of Perthes' disease.

Main Methods:

  • Cross-sectional and longitudinal study of 15 children with Perthes' disease (3-11 years).
  • Measurements included lower leg length, height, weight, IGF-I, IGFBP-3, collagen markers, and bone alkaline phosphatase.
  • Data collected at acute presentation and over a 2-year follow-up period.

Main Results:

  • Height SD scores declined post-presentation; lower leg growth was initially asymmetrical, then ceased and resumed symmetrically.
  • Patients exhibited persistently low IGF-I, reduced soft tissue collagen synthesis, and increased collagen breakdown.
  • Bone formation markers increased during follow-up, suggesting bone healing.

Conclusions:

  • Acute lower leg growth changes reflect altered weight-bearing and immobilization/remobilization phases.
  • Persistently low IGF-I may contribute to reduced soft tissue collagen synthesis and impaired growth.
  • Increased bone formation markers likely indicate bone healing processes in Perthes' disease.
Abstract

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