Treatment

In Legg-Calve-Perthes disease, the complete process of bone death, fracture and renewal can take several years. The types of treatment recommended will depend on the:

• Age when symptoms began
• Stage of the disease
• Amount of hip damage

As Legg-Calve-Perthes disease progresses, the ball part of the joint (femoral head) weakens and fragments. During healing, the socket part of the joint can serve as a mold to help the fragmented femoral head retain its round shape.

For this molding to work, the femoral head must sit snugly within the socket. Sometimes this can be accomplished with a special type of leg cast that keeps the legs spread widely apart for four to six weeks.

Some children require surgery to help keep the ball of the joint snug within the socket. This procedure might involve making wedge-shaped cuts in the thigh bone or pelvis to realign the joint.

Surgery usually isn't needed for children younger than 6. In this age group, the hip socket is naturally more moldable, so the ball and socket typically continue to fit together well without surgery.

Other treatments

Some children, particularly very young ones, might need only conservative treatments or observation. Conservative treatments can include:

• Activity restrictions. No running, jumping or other high-impact activities that might accelerate hip damage.
• Crutches. In some cases, your child may need to avoid bearing weight on the affected hip. Using crutches can help protect the joint.
• Physical therapy. As the hip stiffens, the muscles and ligaments around it may shorten. Stretching exercises can help keep the hip more flexible.
• Anti-inflammatory medications. Your doctor might recommend ibuprofen (Advil, Motrin, IVothers) or naproxen sodium (Aleve) to help relieve your child's pain.