SURGICAL DISEASES, TRAUMATOLOGY, ORTHOPEDICS, UROLOGY : OSTEODYSTROPHIES. Degeneration of the femoral head (Perthes disease) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The etiology and pathogenesis are not fully established. Have the value of trauma and congenital disorders of blood supply to the femoral head. The essence of the process is reduced to aseptic necrosis of the femoral head.
Symptoms. Non-permanent, moderate pain in the hip joint, lameness, limitation of motion.
For. The disease is characteristic of childhood. The process is often one-sided. Develops gradually, without acute onset. Appear moderate pain, lameness, gradually joins the restriction of movements of abduction and rotation of the hip. Non-permanent low-grade fever. The disease lasts from 2 to 6 years.
Recognition on the basis of clinical data, the main characteristic x-ray data; the first stage is necrosis of bone head while maintaining unchanged the cartilage cover; second stage, the head flattened, flattened, structureless, loose body gap widened; the third stage - the head has the appearance of individual bone sections, the joint gap widens even more, the neck of the femur is shortened and thickened; the fourth stage - the stage of reparation, the emergence of the figure of the spongy bone of the head; fifth stage - head takes the correct structural drawing, its shape is spherical or mushroom-shaped, the neck of the femur is shortened, thickened.
In the early stages of restorative treatment, locally traction with the purpose of unloading and subsequent wearing of the unloading apparatus, physiotherapy, mud therapy, physiotherapy. In advanced cases with deformation, difficult walking and causing constant pain, surgical intervention.