Video Explanation: Perthes Disease – What Parents Need to Know

Legg-Calvé-Perthes disease is a condition affecting the femoral head in children, caused by temporary interruption of blood supply. This leads to necrosis (death) and subsequent bone reconstruction, a process that can last 2-4 years. **Who it affects:** Typically children between 4 and 10 years (most frequent between 5 and 7), with a clear male predominance (4:1 ratio). In 80% of cases it's unilateral (one hip only). **Cause:** The exact cause remains unknown. The most accepted hypothesis involves coagulation alterations or microtrauma interrupting femoral head vascularization. It's not hereditary and isn't caused by direct trauma. **Disease phases:** 1. **Necrosis:** Bone loses vitality and the femoral head may fragment. 2. **Fragmentation:** Dead bone is reabsorbed. 3. **Reossification:** New bone gradually forms. 4. **Remodeling:** The femoral head remodels, ideally spherically. **Prognostic factors:** Age is the most important factor: younger children (under 6 years) have better prognosis because they have more time for remodeling. Extent of necrosis, femoral head coverage, and mobility preservation are other key factors. **Treatment:** The goal is to keep the femoral head "centered" in the acetabulum during healing. Options include physical therapy, abduction braces, or in more severe cases, surgery (osteotomy).