Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg-Calvé-Perthes.

IF 1.3 4区 医学 Q3 ORTHOPEDICS Journal of Childrens Orthopaedics Pub Date : 2023-09-25 eCollection Date: 2023-10-01 DOI:10.1177/18632521231203009
Benjamin Joseph, Hitesh Shah, Daniel C Perry
{"title":"Epidemiology, natural evolution, pathogenesis, clinical spectrum, and management of Legg-Calvé-Perthes.","authors":"Benjamin Joseph,&nbsp;Hitesh Shah,&nbsp;Daniel C Perry","doi":"10.1177/18632521231203009","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Legg-Calvé-Perthes disease is a self-limiting disorder that develops in children following interruption of the blood supply to the capital femoral epiphysis. This review outlines the current knowledge on the epidemiology, natural evolution, clinical spectrum, and management of the disease.</p><p><strong>Methods: </strong>The literature pertaining to these aspects of the disease were studied and summarized in this review.</p><p><strong>Results: </strong>Epidemiological studies suggest that environmental factors contribute to the causation of the disease. Incidence rates monitored over time indicate that the incidence of Legg-Calvé-Perthes disease is declining. The natural evolution followed on sequential plain radiographs enables division of the disease into Stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV. Reversible deformation of the capital occurs in Stages Ia-IIa simply on standing while irreversible deformation may occur in Stages IIb and IIIa. Treatment of Legg-Calvé-Perthes disease in Stages Ia-IIa aims to prevent the femoral head from getting deformed by containment and avoidance of weight-bearing. In Stages IIb and IIIa, treatment aims to remedy the effects of early irreversible deformation of the femoral head. In Stage IIIb and IV, treatment is directed to correcting the altered shape of the femoral head. The impression that these treatment methods are helpful is based on poor quality evidence.</p><p><strong>Conclusion: </strong>There is an urgent need to undertake Level I studies to establish the efficacy of currently treatment.</p><p><strong>Level of evidence: </strong>level V.</p>","PeriodicalId":56060,"journal":{"name":"Journal of Childrens Orthopaedics","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2f/cb/10.1177_18632521231203009.PMC10549695.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Childrens Orthopaedics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/18632521231203009","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/10/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Legg-Calvé-Perthes disease is a self-limiting disorder that develops in children following interruption of the blood supply to the capital femoral epiphysis. This review outlines the current knowledge on the epidemiology, natural evolution, clinical spectrum, and management of the disease.

Methods: The literature pertaining to these aspects of the disease were studied and summarized in this review.

Results: Epidemiological studies suggest that environmental factors contribute to the causation of the disease. Incidence rates monitored over time indicate that the incidence of Legg-Calvé-Perthes disease is declining. The natural evolution followed on sequential plain radiographs enables division of the disease into Stages Ia, Ib, IIa, IIb, IIIa, IIIb, and IV. Reversible deformation of the capital occurs in Stages Ia-IIa simply on standing while irreversible deformation may occur in Stages IIb and IIIa. Treatment of Legg-Calvé-Perthes disease in Stages Ia-IIa aims to prevent the femoral head from getting deformed by containment and avoidance of weight-bearing. In Stages IIb and IIIa, treatment aims to remedy the effects of early irreversible deformation of the femoral head. In Stage IIIb and IV, treatment is directed to correcting the altered shape of the femoral head. The impression that these treatment methods are helpful is based on poor quality evidence.

Conclusion: There is an urgent need to undertake Level I studies to establish the efficacy of currently treatment.

Level of evidence: level V.

Abstract Image

Abstract Image

Abstract Image

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Legg Calvé-Perthes的流行病学、自然进化、发病机制、临床谱和管理。
背景:Legg-Calvé-Perthes病是一种自限性疾病,在儿童股骨干骺供血中断后发生。这篇综述概述了该疾病的流行病学、自然进化、临床谱和管理方面的最新知识。方法:对与该病这些方面有关的文献进行研究和总结。结果:流行病学研究表明,环境因素是导致该疾病的原因之一。随着时间的推移,监测到的发病率表明Legg-Calvé-Perthes病的发病率正在下降。根据连续平片的自然演变,可以将疾病分为Ia、Ib、IIa、IIb、IIIa、IIIb和IV阶段。Ia、IIb阶段仅在站立时发生资本的可逆变形,而IIb和IIIa阶段可能发生不可逆变形。Ia-IIa期Legg-Calvé-Perthes病的治疗旨在通过控制和避免负重来防止股骨头变形。在IIb和IIIa阶段,治疗旨在补救股骨头早期不可逆变形的影响。在第IIIb和IV阶段,治疗旨在矫正股骨头形状的改变。这些治疗方法有帮助的印象是基于低质量的证据。结论:迫切需要进行I级研究,以确定目前治疗的疗效。证据级别:五级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
Journal of Childrens Orthopaedics
Journal of Childrens Orthopaedics Medicine-Orthopedics and Sports Medicine
CiteScore
2.70
自引率
14.30%
发文量
61
审稿时长
23 weeks
期刊介绍: Aims & Scope The Journal of Children’s Orthopaedics is the official journal of the European Paediatric Orthopaedic Society (EPOS) and is published by The British Editorial Society of Bone & Joint Surgery. It provides a forum for the advancement of the knowledge and education in paediatric orthopaedics and traumatology across geographical borders. It advocates an increased worldwide involvement in preventing and treating musculoskeletal diseases in children and adolescents. The journal publishes high quality, peer-reviewed articles that focus on clinical practice, diagnosis and treatment of disorders unique to paediatric orthopaedics, as well as on basic and applied research. It aims to help physicians stay abreast of the latest and ever-changing developments in the field of paediatric orthopaedics and traumatology. The journal welcomes original contributions submitted exclusively for review to the journal. This continuously published online journal is fully open access and will publish one print issue each year to coincide with the EPOS Annual Congress, featuring the meeting’s abstracts.
期刊最新文献
Preoperative Gallows traction as an adjunct to hip open reduction surgery: Is it safe and is it effective? Pre-operative Gallows traction as an adjunct to hip open reduction surgery: Is it safe and is it effective? One-bone forearm for the treatment of supination contractures secondary to neonatal brachial plexus injury. Acute postoperative complications after spine deformity correction in patients with Down syndrome. Odontoid fractures in the pediatric population: a systematic review and management algorithm.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1