Legg-Calvé-Perthes Disease: A Comparative Study

Abstract

lowe a debt of deep gratitude to Dr. Meyer for the part he has taken in my studies, for numerous discussions, oral and in writing, through the years, and for his never failing and ever vivid interest in the job. For access to the files of case notes and X-ray films in the Refsn~s Hospital I am greatly indebted also to its present Head, Hans Bohr, M.D., who displayed a constant interest in the progress and results of the study and contributed by instructive discussions. Thanks are due, moreover, to the staff of the Refsn~s Hospital for extensive obligingness and help as well as for hospitality during my visits to collect data. . The investigations were continued while I was working in the Orthopaedic Department run by the Society and Home for the Disabled in Odense. Thanks are due to my chiefs in that Department, K. Harry S¢rensen, M.D., and A. Randl¢v, for their interest and for the access to that part of the Thomas caliper series which had been treated in Odense. The normal material too was collected in Odense. During my appointment as research assistant to the Anatomy Department of the Odense University I had ideal working conditions for combining and writing up all the data. I am thankful to Professor F. Bierring, Head of the Department, who also took an intense interest in the investigation of the vascularization of child hips which I carried out during that period. My thanks are due also to members of the Department staff who rendered help in various ways and took part in the studies. For careful typing of the book I would like to thank Jonna Madsen, medical secretary. The statistical calculations were performed by H. K. Kvist, M.Sc., to whom I am indebted for incredibly speedy help in a part of the study which I had no possibilities of solving myself.Last, but not least, I want to thank my wife, Hanne, for her great practical help, at many late hours, in recording the numerous data on punch cards (Karlo Hansen system), and for her enormous patience during all the years that this study took so much of the spare time which I ought .to have spent with my family. It is, therefore, a great pleasure to dedicate this book to my wife and children.

Does Prolonged Weight Relief Increase the Chances of a Favourable Outcome After Containment for Perthes Disease?

“…The aim of the treatment of LCPD is to prevent the femoral head from getting deformed and the strategies for the treatment revolve around 2 concepts; containment and weight relief. Weight relief was popular 50 years ago 13,14 but in more recent times, it is seldom practiced largely because of the concern regarding the possibility of adverse psychological effects on the child. The current trend is to rely solely on containment, ignoring the role of weight relief.…”

Adult paleopathology as an indicator of childhood social roles: A case study of Perthes disease in a native Ohio female

“…In the first stage of LCPD, blood flow to the medial circumflex artery is restricted (Berthaume et al, ). Although the precise aetiology of the ischemia is unknown (Alpaslan, Aksoy, & Yazici, ), such restriction can be caused by extension of the hip (e.g., standing), which stretches the medial circumflex artery over the tendon of the external obturator (Lauritzen, ). Children in whom the medial circumflex artery lies deep to the external obturator tendon are at an elevated risk for artery restriction because the artery can become entrapped within the external obturator tendon and the joint capsule of thLauritzene hip (Lauritzen, ).…”

“…Although the precise aetiology of the ischemia is unknown (Alpaslan, Aksoy, & Yazici, ), such restriction can be caused by extension of the hip (e.g., standing), which stretches the medial circumflex artery over the tendon of the external obturator (Lauritzen, ). Children in whom the medial circumflex artery lies deep to the external obturator tendon are at an elevated risk for artery restriction because the artery can become entrapped within the external obturator tendon and the joint capsule of thLauritzene hip (Lauritzen, ). The restriction of the medial circumflex artery reduces blood supply to the femoral head and weakens the bone, which then fractures in the second stage (Berthaume et al, ).…”

Delayed ossification of the proximal capital femoral epiphysis in Legg-Calvé-Perthes’ disease

“…We did not investigate the reasons why more children do not develop bilateral disease. Lauritzen 16 showed that the peak age for developing bilateral Perthes' disease was ear- lier than that for unilateral disease, which they attributed in part to a relatively large number of patients with dysplasia epiphysealis capitis femoris. Edvardsen, Slordahl and Svenningsen 17 showed that retardation of bone age was more marked in children with bilateral disease than in those with unilateral involvement.…”