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Outcome after conservative treatment of Perthes' disease in children
Wojciech Radło1, Jerzy Sułko, Dariusz Kotulski
1Oddział Ortopedyczno-Urazowy, Uniwersytecki Szpital Dzieciecy, CM UJ, Kraków.
Insights
Conservative treatment for Perthes disease, including crutches for load relief, exercises, and traction, effectively reconstructs the femoral head and improves function. Patient age and disease severity are key factors for successful outcomes.
Area of Science:
- Pediatric Orthopedics
- Pediatric Rheumatology
Background:
- Perthes disease affects children, causing femoral head deformity.
- Conservative management aims to preserve joint function and morphology.
Purpose of the Study:
- To evaluate outcomes of a specific conservative treatment algorithm for Perthes disease.
- To compare results with existing literature on Perthes disease management.
Main Methods:
- Analysis of 38 children (2.5-10 years) treated between 1995-2003.
- Homogeneous conservative treatment: range-of-motion exercises, pool therapy, crutch use for load release, and indirect traction.
- Clinical and radiological assessments for outcome evaluation.
Main Results:
- All patients showed femoral head reconstruction after an average 3.8-year follow-up.
- Good functional outcomes were achieved irrespective of patient age at treatment onset.
- Treatment effectiveness was comparable to other conservative methods reported in literature.
Conclusions:
- Conservative treatment utilizing crutches, kinesitherapy, and traction yields favorable results for Perthes disease.
- Early diagnosis and appropriate management based on age and disease stage are crucial.
- Staheli's algorithm provides a viable conservative approach for Perthes disease.
Abstract:
Background. This article presents outcomes after conservative treatment of Perthes' disease according to Staheli's algorithm. Material and methods. We analyzed 38 children (30 boys and 8 girls), ranging in age from 2.5 to 10 years, who were treated in the period 1995-2003 using a homogeneous conservative method. Treatment consisted in the application of exercises to increase or maintain a full range of movement, swimming pool exercises, load release on the limb (crutches), and indirect traction. Clinical and radiological examinations were used to assess the outcome, and the results of this method were compared to the outcomes described in the literature. Results. In all subjects, after an average 3.8-year observation period, we observed reconstruction of the femoral head and a good functional outcome, regardless of age. Conclusions. Treatment of Perthes' disease by using crutches to relieve limb load, and by applying kinesitherapy and traction, allows for good results, comparable to those achieved with other conservative methods. The most decisive factors for treatment outcome are the child's age at onset and the degree of advancement of the changes.
