Summary
Since 1975, none of our patients with Perthes' disease have received any active treatment, except for managing severe pain. We have studied the functional and radiological results in order to evaluate the consequences of this approach and to demonstrate the natural history of the disease. We have followed up all patients over the age of 19 years; out of 20 only 6 were free of pain and only 2 reached 100 points on the Iowa hip score. Radiographs at follow up demonstrated that no involved hip had a spherical femoral head. We conclude that our passive attitude towards Perthes' disease results in relatively few patients having good hip function, especially when compared with the results of other authors. Active treatment, including operation, is probably more successful.
Résumé
Depuis 1975, aucun de nos patients, atteints de maladie de Legg-Perthes-Calvé, n'a été traité de façon active, sauf en cas d'importantes douleurs. Nous avons étudié les résultats cliniques et radiologiques afin d'évaluer les conséquences de cette attitude et de préciser l'histoire naturelle de la maladie. Nous avons suivi tous les patients au delà de l'âge de 19 ans. Sur les 20, seulement 6 n'avaient aucune douleur et deux seulement atteignaient 100 points sur la cotation de hanche de l'Iowa. Les radiographies montraient qu'aucune des hanches atteintes n'avait une tête fémorale sphérique. Nous en concluons que notre attitude passive vis-à-vis de la maladie de Legg-Perthes-Calvé n'apporte un bon résultat fonctionnel qu'à un relativement petit nombre de malades, surtout si on la compare aux résultats d'autres auteurs. Un traitement actif, éventuellement chirurgical, est probablement meilleur.
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Norlin, R., Hammerby, S. & Tkaczuk, H. The natural history of Perthes' disease. International Orthopaedics 15, 13–16 (1991). https://doi.org/10.1007/BF00210525
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DOI: https://doi.org/10.1007/BF00210525