Legg

Calve
Perthes

DEFINITION:
Legg Calve Perthes Disease is when the hip of the
thighbone (femur) deteriorates due to the
insufficiency blood supply to the area.
The blood flow to the femur is interrupted, and the

SIGNS ANS SYMPTOMS:

Hip, knee or groin pain
Atrophy of muscles in the upper
thigh.
Slight shortening of the legs, or legs
of unequal length
ETIOLOGY:
Difficulty
walking
Hip stiffness
Idiopathic, but may consider:
Limited range of motion
Delayed bone age
Disproportionate growth
Mildly shortened stature
Or as a result of:
Slipped capital femoral
epiphysis
Trauma
Sickle-cell crisis
Toxic synovitis
Congenital dislocation of the
hip

DIAGNOSTIC PROCEDURES:
X-ray will show a small, flattened and fragmented head of the
femur.
Bone scan determine the extent of the avascular changes.
MRI is useful for judging the extent of the deformity.

INCIDENCE:
Race: Caucasians are affected more frequently than persons
of other races.
Sex: Males are affected 4-5 times more often than females.
Age: Most commonly seen in persons aged 3 12 years with
a median age of 7 years.

STAGES:
Legg Calve Perthes disease goes through four stages of changes that affect
the head of the femur. The stage includes:
Stage 1 - avascular
- Blood supply is absent to the femoral head and the hip joint becomes
inflamed, stiff, and painful. Portions of the bone turn into dead tissue. The
ball of the thigh bone becomes less round in appearance on x-rays. This
phase can last from several months up to one year.
Stage 2 fragmentation or revascularization
TREATMENT:
- The body cleans up the dead
bone cells and replaces them with new
healthier
bone
Bed
restcells. The femoral head begins to remodel into a round
shape again.
The joint is still irritated and painful. This stage can last from
Analgesics
one to three
years.
Traction
Stage 3 - reparative
Plaster cast
- The femoral head continues to model itself back into a round shape with
External fixator
new bone. This stage last for one to three years.
Use of cane and crutches
Stage 4 - regenerative
Swimming is highly recommended
- Normal bone cells replace the new bone cells. This last stage cab last a
The goal it to avoid degenerative arthritis and
few years to complete the healing process.
removing pressure from the joints until disease has
run its course

NURSING INTERVENTIONS:

Position the patient in comfortable way

Assess patient condition
Note emotional responses to problem of immobility
Encourage verbalize of the feeling about pain
Position extremities in proper alignment with gentle movement
Maintain bed rest
Limit activity
Instruct correct body mechanics and body posture
Determine clients acceptable level of pain 1 to 10 pain scale