Abstract
The treatment of Legg-Calvé-Perthes disease remains controversial. The aim of this survey was to ascertain the current management strategies of this condition amongst UK paediatric orthopaedic surgeons, with particular regard to containment procedures in the fragmentation phase. Questionnaires were distributed at the January 2006 meeting of the British Society for Children's Orthopaedic Surgery (BSCOS) and was posted to all absent members. The results showed a great deal of variability not only in the treatment of Perthes disease, but also in the decision-making processes. Consideration must now be given to a carefully constructed national multi-centre prospective randomised controlled study into the optimum management of this disease.
Highlights
The treatment of Legg-Calve-Perthes disease remains controversial
The need for an arthrogram was determined by several factors, which came under three headings in the questionnaire: history, examination and radiological features
As evident from the above survey, there is a wide variation of opinion regarding the management of Perthes disease amongst the paediatric orthopaedic surgeons of Britain
Summary
The treatment of Legg-Calve-Perthes disease remains controversial. The aim of this survey was to ascertain the current management strategies of this condition amongst UK paediatric orthopaedic surgeons, with particular regard to containment procedures in the fragmentation phase. Legg-Calve-Perthes disease is a childhood hip disorder occurring most commonly in the age range of 4–8 years [1]. The outcome in terms of the resultant shape of the femoral head is difficult to predict, as it varies from patient to patient and depends partly on age at presentation, the proportion of the head involved and the severity of the disease. It is, difficult to formulate individual patient treatments. Most studies of current treatment methods lack interrater and intrarater reliability of classifications of the extent of epiphyseal involvement and outcome measures, and all lack control groups. The cornerstone of treatment for Legg-Calve-Perthes syndrome is referred to as ‘‘containment.’’ This concept was originally described by Harrison and Menon [2] and Eyre-Brook [3]
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