Aktuelle Behandlungsstrategie des Morbus Perthes

The long-term prognosis of Legg-Calvé-Perthes disease primarily depends on the spherical form of the femoral head and the congruency of the hip joint after healing. Of the many factors influencing the outcome only the range of mobility and containment can be addressed therapeutically. The mobility of the joint is maintained or restored through various conservative measures thus reducing joint deforming forces. If loss of containment becomes evident operative treatment is indicated, preferably in the early fragmentation stage. For biomechanical reasons correction of the acetabulum is preferred. For children less than 8.5 years old greater trochanteric apophyseodesis is warranted to prevent trochanteric overgrowth. The results of containment ameliorating surgery are promising. In older children with severe Legg-Calvé-Perthes disease the results are less promising.