Medical treatment is the mainstay of most cases.
Your Perthes specialist will be able to advise you on different treatments depending on the age of onset of the disease and the degree of involvement.
Any treatment should aim to promote joint mobility and improve or eliminate the symptoms of pain and contracture.
The hip should move in its normal ranges to avoid deformity. When we achieve good ranges of mobility, we ultimately favor better sphericity and therefore a better prognosis.
Any medical action will be aimed at symptomatic improvement in children:
- Relieve pain
- Decrease limping
- Promote mobility.
Many other treatments have been abandoned for not having a beneficial effect on the disease.
In case of doubt, contact a Perthes specialist for a second opinion.
Universal treatments consist of:
- physiotherapy measures to promote hip movement
- pain control with anti-inflammatory children’s drugs
- decrease the overload of the hip. Not necessarily to stop supporting the leg
- absolute rest is not usually indicated
- measures of opening of the hips at times when the child is seated
- avoid contractures of the adductor muscles
ABANDON THE "DON'T JUMP, DON'T RUN".
INTENSE AND PROLONGED REST IS WORSE.
We know that leg separation, or abduction, is the best way to treat hip contracture, and therefore prevents the dreaded subluxation. Our group designed a foam lined splint that maintains hip abduction better than any other. It is part of the universally accepted method of containment. Use it when we recommend it.
This type of chair also favors the separation of the hips and therefore any similar system could improve the contracture process.