Legg-Calve-Perthes disease: clinical analysis of 57 cases

The rarity of the Legg-Calve-Perthes disease (LCPD) in Chinese children in Hong Kong has been reported. However, this hip disorder is not uncommon among children in Taiwan between the ages of 3 and 9. Fifty-seven patients with LCPD were observed during a 4-year period. Of these, 47 hips in 43 patients were followed up through a significant course of the disease, with an average period of 38.8 months. The mean age at onset of symptoms was 6.6 years for boys and 7.1 years for girls. Over half of the patients (67%) were older than 6 years of age at onset of the disease. The male: female ratio was 5:1, and the incidence of bilateral involvement was 10%. The majority (85%) belonged to Catterall's group 3 or 4. The skeletal maturity of 17 (68%) these children was delayed an average of 31.8 months. Fifty-three percent of the patients were from families of low socioeconomic status. Delay in diagnosis and presentation with painless limp and stiffness were common. Orthotic management was employed in 15 hips. Surgical containment, either by varus-rotation femoral osteotomy or innominate osteotomy, was achieved in 16 hips. The remaining 16 hips received no treatment. The overall results showed an increase in improvement from 19% to 47% after active treatment of the disease. The chance of satisfactory treatment was reduced considerably when the disease started after the age of 6 years, this was especially obvious in untreated hips. No significant differenced in the healing time between the nonsurgical group and the surgical group was observed.