Publication:

Clinical observation of early rehabilitation of childhood femoral head necrosis in a low stress environment

Background Objective: To observe and study early rehabilitation processes in children with femoral head necrosis (Perthes disease) in a low stress environment.

Methods Twenty-eight symptomatic patients underwent surgery. The effected coxa was supported with a coxa multi-functional external fixation, which created a low stress environment in the patient’s hipbone. Complete data and documentation of follow-up were received in this research. The preoperative and postoperative changes in iconographical features were observed, thickness of epiphysis and degrees of hip flexion and extension were examined.

Results Follow-up ranged from 2 to 7 years (mean 41 months), postoperative clinical complications were slight in all of the patients. Radiographic evaluation showed that the deformed groove caused by high pressure of the upper outside of femoral head was repaired under a low stress environment. High density necrosis shadows shrank rapidly within three months. The thickness of the epiphysis was obviously increased (P <0.01), and the femoral head gradually became plump. Activities of the hip such as flexion and extension were significant improvement (P <0.01).

Conclusions Under a low stress environment, femoral head necrosis in children was repaired. The groove, high density necrosis head and thickness of epiphysis were important features of femoral bone repair in children. The efficiency of repair was directly related to a low stress environment and the extent of the disease.