Legg-Calvé-Perthes Disease

Herring, John A.; Kim, Hui Taek; Browne, Richard

doi:10.2106/00004623-200410000-00001

Cited by 254 publications

(57 citation statements)

References 55 publications

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“…Moreover, prolonged initial and fragmentation stages are associated with a worse prognosis. Several events occur during the fragmentation period, including subluxation of the femoral epiphysis and collapse of the lateral pillar, that increase the risk for permanent femoral head deformity [10,13]. Accordingly, the duration of the initial stage positively correlates with that of the fragmentation stage, and in such cases, even if patients with LCPD are under 6 years of age, they may require active treatment such as surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, two orthopedic surgeons (HSO and SK) reviewed the standard anteroposterior and frog-leg radiographs of the hips throughout the treatment course (Figure 1). To evaluate disease severity, we applied the lateral pillar classification when the disease showed maximal epiphyseal fragmentation in the fragmentation stage [12,13]. To determine the Waldenström class, the interval between the first radiograph showing features of one stage and the first radiograph showing features of the next stage was determined as the duration of the stage.…”

Section: Methodsmentioning

confidence: 99%

“…The final outcome was evaluated radiographically using the Stulberg classification. The Stulberg class was determined from radiographs at the time of skeletal maturity, and patients without skeletal maturity at the final follow-up were excluded (Figure 1D) [13]. Stulberg classes I and II were considered to be good, III to be fair, and IV and V to be poor.…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Does the Duration of Each Waldenström Stage Affect the Final Outcome of Legg–Calvé–Perthes Disease Onset before 6 Years of Age?

Oh¹,

Sung²,

Lee³

et al. 2021

Children

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The purpose of this study was to evaluate the outcomes of patients with Legg–Calvé–Perthes disease (LCPD) with disease onset before 6 years of age who were treated with conservative methods and to identify prognostic factors. Moreover, we evaluated the duration of the Waldenström stage and its correlation with the disease outcome. Disease severity was assessed using the lateral pillar classification, and the final outcome was evaluated using the Stulberg classification. We divided patients with LCPD into two groups according to the age at onset: group 1 (<4 years) and group 2 (4–6 years). The final outcomes of the two groups were compared. We also assessed the duration of each Waldenström stage. LCPD was noted in 49 hips of 49 patients. The lateral pillar class was A in one patient, B in 29 patients, and B/C or C in 19 patients. The Stulberg class was I or II (good) in 30 patients, III (fair) in 13 patients, and IV or V (poor) in six patients. The lateral pillar class significantly correlated with the final outcome. Groups 1 and 2 comprised 25 and 24 patients, respectively. The prevalence of good outcomes did not significantly differ between the groups (p = 0.162). The duration of the initial stage was 4.1 months in the good outcome group and 6.2 months in the fair or poor outcome group. The duration of the fragmentation stage of the femoral head was 5.9 months in the good outcome group and 11.9 months in the fair or poor outcome group. The durations of initial and fragmentation stages significantly differed between good outcome group and fair or poor outcome group (p = 0.009 and p < 0.001, respectively). The prognosis of patients with disease onset before the age of 6 years was favorable. The disease severity and duration of each Waldenström stage can be predictors of the outcome. Patients with prolonged initial and fragmentation stages showed worse outcomes and often required more active treatment to shorten the durations of the initial and fragmentation stages.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Does the Duration of Each Waldenström Stage Affect the Final Outcome of Legg–Calvé–Perthes Disease Onset before 6 Years of Age?

Oh¹,

Sung²,

Lee³

et al. 2021

Children

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“…Bazen kalçada fleksiyon ve adduksiyon kontraktürü bulunabilir, bu da o taraf ekstremitede görünüşte kısalığa neden olur. Kalça eklemindeki hareket kısıtlılığı ve ağrıya bağlı topallama zamanla uyluk çevresindeki kaslarda atrofiye neden olur [4]. Laboratuvar: LCP hastalığında laboratuvar testlerinde bir değişiklik yoktur.…”

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“…Eğer femur başında şekil bozukluğu gelişirse asetabulumla uyumsuz olacak ve erken yaşta kalça ekleminde dejenerasyon, yani koksartroz gelişecektir. Her ne kadar hastalığın prognozunda baş tutuluşu önemli bir faktörse de, tedavinin uygun yapılıp yapılmaması da önemlidir [3][4]. Hastalığın seyrinde aseptik nekroz ve rejenerasyon dönemlerinde kemiğin içyapısı, trabeküler sistem önemli ölçüde bozulmuştur.…”

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Osteochondroses

Atay¹

2015

Orthopaedics and Sports Medicine Guide for Researchers

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Legg-Calve-Perthes hastalığı çocukluk çağında femur başının kanlanmasının bozulmasıyla ortaya çıkan bir aseptik nekrozdur. Hastalığın etiyolojisi bugünkü bilgilerimize göre kesin değildir. Travma, alerji, enfeksiyon ve artmış kan viskozitesinin hastalığı başlatan etken olabileceği öne sürülmüştür. İlk defa 1910 yılında Alman Perthes, Amerikalı Legg ve Fransız Calvé tarafından ayrı ayrı tanımlanmıştır. Bu tarihten önce hastalık kalça eklemi tüberkülozu ile karıştırıldığı için "psödokoksalji" adı verilmiştir [3]. Görülme Sıklığı: Perthes hastalığının görülme sıklığı ırksal ve coğrafi farklılıklar göstermektedir. Hastalık en sık 4-9 yaşlar arasında görülmekle birlikte, 2-13 yaşları arasında da ortaya çıkabilmektedir. 6 yaşında görülme oranı zirveye ulaşır. Olguların sadece %10'u iki taraflıdır ve erkeklerde 4 kat daha fazladır. Hereditenin LCP hastalığının gelişimi üzerinde belirgin bir rolü olmadığı kanıtlanamamıştır. Buna karşın LCP hastalıklı çocukların boyları normal popülasyona göre 3-6cm daha kısadır. Patoloji: LCP hastalığında femur başında değişen derecelerde avasküler nekroz ve farklı evrelerde tamir olayı vardır. Hastalık kanlanmanın bozulmasıyla başlar ve belli bir süre sonra nekrotik kemik ve kemik iliği rezorbe edilir ve yerine immatür kemik dokusu oluşturulur. Bu evrede femur başı ileri derecede yumuşar ve kalıcı deformiteler oluşabilir. Klinik: En belirgin yakınma ağrı ve topallamadır. Ağrı kalça çevresinde, uyluğun ve dizin iç yüzünde hissedilir. Kalça ekleminin duysal innervasyonunu sağlayan obturator sinirin dağılma bölgesine uyan, dizin iç yüzüne vuran ağrı tanıda önemlidir. Perthes

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Common Childhood Orthopaedic Conditions, their Care and Management

Judd

2014

Orthopaedic and Trauma Nursing

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Legg-Calvé-Perthes Disease

Cited by 254 publications

References 55 publications

Does the Duration of Each Waldenström Stage Affect the Final Outcome of Legg–Calvé–Perthes Disease Onset before 6 Years of Age?

Does the Duration of Each Waldenström Stage Affect the Final Outcome of Legg–Calvé–Perthes Disease Onset before 6 Years of Age?

Osteochondroses

Common Childhood Orthopaedic Conditions, their Care and Management

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