Perthes disease is avascular necrosis of the femoral head with no known cause. There is a risk, more commonly in older children (over the age of 6), of a significant and permanent deformation of the femoral head leading to long-term problems. We offer prophylactic surgical treatment in patients over the age of 6 in the early stages of the disease. Surgical treatment is also offered in children with hip subluxation and other unwanted consequences of the disease such as impingement.
Prophylactic treatment entails either a femoral varus osteotomy (see Dr Zenios’ paper) or hip distraction using an external fixator. Hip distraction is an innovative technique which aims to maintain the sphericity of the femoral head and the anatomy of the hip joint, reducing the incidence of pain and osteoarthritis later on in life.
