Avascular necrosis of the femoral head (Legg–Calvé–Perthes disease) is a pathological condition in which the blood supply to the femoral head is disrupted, leading to bone necrosis, collapse, and deformation of the hip joint. The disease most commonly affects children aged 4–10 years and requires comprehensive treatment aimed at restoring blood flow and preventing joint deformity.
Causes and risk factors
- Impaired blood supply to the femoral head.
- Trauma and repetitive microtrauma to the hip joint.
- Hormonal changes and metabolic disorders.
- Congenital hip dysplasia.
- Autoimmune diseases and chronic infections.
Symptoms of avascular necrosis of the femoral head in children
- Hip pain radiating to the knee.
- Limping and restricted mobility.
- Reduced range of motion in the hip joint.
- Thigh muscle atrophy and leg length discrepancy.
- Pain that worsens with weight-bearing and prolonged walking.
How is Legg–Calvé–Perthes disease diagnosed?
- Hip X-ray. Allows detection of necrotic changes and deformity of the femoral head.
- Hip MRI. Determines the extent and stage of bone involvement.
- Doppler ultrasound of blood vessels. Identifies impaired blood flow in the hip region.
- Blood tests. Help exclude inflammatory and autoimmune conditions.
Treatment methods for avascular necrosis of the femoral head in children
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Orthopedic management. Use of braces, orthoses, or casting to unload the affected joint. Physiotherapeutic modalities are applied to improve local blood circulation.
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Medical therapy. Medications that improve blood flow (vasodilators, antiplatelet agents). Anti-inflammatory drugs for pain control. Chondroprotective agents to support cartilage regeneration.
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Physical therapy and rehabilitation. Therapeutic exercises to restore joint mobility and prevent muscle atrophy. Magnetotherapy, electrical stimulation, and laser therapy may be used.
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Surgical treatment (in severe cases). Osteotomy to realign the femoral head and redistribute load. Core decompression to improve intraosseous blood flow. Total hip arthroplasty is rarely required and usually considered only in adolescents with irreversible joint damage.
Advantages of modern treatment approaches
- Early diagnosis allows full preservation of hip joint function.
- Physiotherapy and orthopedic management help prevent femoral head deformity.
- Surgical interventions are reserved for advanced or refractory cases.
- A multidisciplinary approach reduces the risk of complications and long-term disability.
Advantages of treating avascular necrosis of the femoral head in children in Belarus
In Belarus, treatment of avascular necrosis of the femoral head is provided at leading orthopedic and rehabilitation centers equipped with modern diagnostic tools and advanced conservative and surgical techniques. A comprehensive, multidisciplinary approach enables restoration of hip joint function and helps prevent long-term complications.
