Scholarlink

Background <p>Early-onset Legg-Calvé-Perthes disease (LCPD) carries a&#xa0;favorable prognosis in the majority of cases; key determinants of outcome are adequate containment (acetabular coverage) of the femoral head and preservation of range of motion during the initial Waldenström stages.</p> Decision-making <p>We present practical classifications and a&#xa0;treatment strategy that prioritizes conservative management and focuses operative interventions on “hips at risk.” In children younger than approximately 6&#xa0;years of age, treatment includes activity modification and dedicated ROM therapy. “Hip-at-risk” signs—particularly progressive decentering of the femoral head—identify the subgroup that benefits from early containment surgery.</p> Therapy <p>Proximal femoral varus osteotomy is technically straightforward and widely established; its limitations include limb-length discrepancy and potential worsening of an existing abductor weakness; in childhood, pelvic Tönnis triple osteotomy addresses containment most comprehensively in LCPD and, in experienced hands, can be performed with low morbidity and early mobilization. As a&#xa0;general principle, the procedure should be selected that most reliably restores containment for the individual hip and with which the treating center has the greatest expertise.</p> Conclusion <p>Centralization of care would be desirable to generate robust long-term data and guidelines for this—perhaps surprisingly—insufficiently standardized condition.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Morbus Perthes im frühen Kindesalter: konservativ versus operativ

  • 期刊论文

  • 发表日期：

    2026年3月24日

查看全文
  • Ferdinand Wagner,
  • Felix Endres

摘要

Background

Early-onset Legg-Calvé-Perthes disease (LCPD) carries a favorable prognosis in the majority of cases; key determinants of outcome are adequate containment (acetabular coverage) of the femoral head and preservation of range of motion during the initial Waldenström stages.

Decision-making

We present practical classifications and a treatment strategy that prioritizes conservative management and focuses operative interventions on “hips at risk.” In children younger than approximately 6 years of age, treatment includes activity modification and dedicated ROM therapy. “Hip-at-risk” signs—particularly progressive decentering of the femoral head—identify the subgroup that benefits from early containment surgery.

Therapy

Proximal femoral varus osteotomy is technically straightforward and widely established; its limitations include limb-length discrepancy and potential worsening of an existing abductor weakness; in childhood, pelvic Tönnis triple osteotomy addresses containment most comprehensively in LCPD and, in experienced hands, can be performed with low morbidity and early mobilization. As a general principle, the procedure should be selected that most reliably restores containment for the individual hip and with which the treating center has the greatest expertise.

Conclusion

Centralization of care would be desirable to generate robust long-term data and guidelines for this—perhaps surprisingly—insufficiently standardized condition.