What is Legg-Calve-Perthes Disease?

Legg-Calve-Perthes disease, also known as Perthes disease, 儿童髋关节疾病通常发生在4到10岁之间吗.

The hip is made up of the femoral head — the “ball,髋臼是股骨的上部，髋臼是环绕股骨头的“杯子”.

在珀尔特斯病中，股骨头的血液供应中断. The femoral head then “necroses,” or loses blood supply, 这会削弱骨骼并导致多处骨折. Next, the bone is taken up by the body, or resorbed, 什么会导致股骨头完全塌陷.

血液供应最终会恢复，骨骼会重新形成，或重新骨化. 然而，骨头可能会以与以前不同的形状重新形成. Because of this, degenerative joint disease (osteoarthritis) can develop later in life.

What causes Legg-Calve-Perthes disease?

There are several theories. 如上所述，股骨头的血液供应丧失. The reasons for this, however, are unclear. 这可能是由于创伤损害血管或疾病导致血液凝结和堵塞静脉.

legg - calf - perthes病的危险因素是什么?

腿-小牛-珀特氏病影响不到总人口的1%，因此非常罕见, but it is four times more common in boys than girls.

研究还表明，父母患有这种疾病的孩子更有可能患上这种疾病. In fact, 2%到10%的珀尔塞斯病患儿至少有一名家庭成员患有该疾病.

legg - calf - perthes病的症状是什么?

患有legg - calf - perthes病的儿童通常会出现明显的跛行. 他们也可能会经历髋关节僵硬或抱怨腹股沟区域的轻微疼痛, thigh or knee. 这种疼痛通常在活动时加重，休息后减轻.

了解儿童和青少年髋关节周围畸形网络研讨会

- Watch on YouTube

看看我们的矫形儿科专家，亚伦·勃兰特博士.D., as he discusses developmental hip dysplasia, slipped capital femoral epiphysis, 珀特氏病和其他髋关节疾病.

Legg-Calve-Perthes Disease Diagnosis

儿童矫形专科医生会检查孩子是否有旋转腿的问题. The thigh, calf and buttock muscles can “atrophy,” or become smaller, if the affected limb goes a long time without use. 专家可能还会注意到，在Perthes病已经持续很长时间的情况下，受影响的腿比正常的腿短.

如果怀疑患有腿-小牛-珀尔塞斯病，医生会给孩子的臀部拍x光片. Often, 还建议进行专门的核磁共振扫描，以确定髋关节的血液供应受到了多大影响.

Legg-Calve-Perthes Disease Treatment

Nonoperative Treatment

It is very important to keep the joint moving. 这是因为股骨头上的软骨取决于关节中的液体, called the synovial fluid, for its nutrition. 移动臀部有助于为软骨提供这种液体.

保持头部在髋臼内也是很重要的，这样当骨头重新形成时, it has the best and most round shape possible. 有时，孩子的臀部变得僵硬，可能需要帮助将球保持在杯子里. 你的医生可能会建议一段时间的铸造、支撑和/或物理治疗来帮助实现这一目标.

Surgical Treatment

手术治疗legg - calf - perthes病是合理的, 但通常不建议6岁以下的儿童服用. The goal of surgery is containment. 目的是将股骨头留在髋臼内. To do this, 儿科骨科医生可能会改变股骨和/或髋臼的角度，并将其固定在更符合解剖学的位置. 这种手术称为截骨术，可以使股骨头以正常的球形方式生长. 

legg - calf - perthes病有并发症吗?

Yes. 股骨头可能失去其正常的球形和/或塌陷. Also, degenerative joint disease can occur (i.e., as occurs in osteoarthritis). 受影响的腿可能会失去一些运动能力，并可能变得比正常的腿短.

我患有腿-小牛-珀尔斯病的孩子将来会怎么样?

This varies from patient to patient. 某些症状的出现通常预示着较差的预后. 这些包括当孩子超过8岁时发展为legg - calf - perthes病, 即使在治疗后也会出现活动范围差和非圆形股骨头.

在大多数患者中，疼痛在青少年时期消退. However, 据估计，在儿童时期患有legg - calf - perthes病的患者中，约有50%在成年后需要进行髋关节置换术.e., 50 to 60 years old).