Limp
Calve-Legg-Perthes (Latin name)By Bjarne Lühr Hansen PhD, MD and Philipp Skafte-Holm MD, Mentor Institute
Calve-Legg-Perthes Disease (CLPD) is often seen with children in the age of 3 to 12 years old. 4 out of 5 cases are boys. The pains in hip, thigh or knee are insidious. Later the child begins to limp and tries to avoid walks. The diagnosis is made by examination with X-rays. The treatment is lengthy and depends on the child’s age and how severe the illness is. Far most children fully recover. In the long term, there is a higher risk for developing osteoarthritis in an early age.
CLPD is an ailment of the hip typically seen with children in the age of 3 to 12 years old. The ailment strikes children 5 times more frequently than girls. The nuisances are insidious. At first, light pains in knee, groin or thigh appear. The child wants to be carried. Later, the child begins to limp and complains during the night. The child can wake up crying because of the pains.
In the case of CLPD, the blood supply to the femoral head in the hip joint fails. It is unknown why the blood supply fails but it has been established that it is hereditary. When the blood supply fails the femoral head starts to break down. The break down is gradual and takes place over several months. At some point the breaking down of the bone stops and the femoral head slowly rebuilds. The whole process from breaking down of the bone to the rebuilding of it can last up to 3 years. CLPD is discovered by examination with X-rays where it is visible that the femoral head is breaking down.
The treatment of CLPD depends on the severity of the illness and the child’s age. Pain must be reduced. However, at the same time it is important to train the movement of the hip and daily exercises with a physiotherapist is often used. It is important that the child’s day care or school is informed. The smallest children (<7 years) are treated with a splint to spread their legs. The child quickly gets used to walking with it and can both play and run. The older children (>7 years) can be treated with operation, if relief is not enough to lessen the pain or if the femoral head is severely damaged.
Far the most children with CLPD fully recover and can after the treatment has finished live a normal life. This is because even though the illness breaks down the femoral head, it rebuilds it later. However, in the long term there is a risk for developing osteoarthritis in an early age – which means around 40 years old.