Pediatric Nursing Demystified

Legg-Calvé-Perthes Disease

What Went Wrong?

Legg-Calvé-Perthes disease is a necrosis of the femoral head that occurs in

children between 2 and 12 years of age caused by a decreased blood supply

to the femoral head. This disease is self-limiting, and the child will fully

recover after the disease has run its course.

There are three stages of Legg-Calvé-Perthes disease:

Avascular: Blood supply to the head of the femur is interrupted within

1 year.

Revascularization: Creeping substitution occurs where connective and

vascular tissue enter the necrotic bone causing live noncalcified bone to

replace the necrotic tissue.

Healing: The bone ossifies over 3 years.

Signs and Symptoms

Painless limp

Pin in the knee during activity

Pain in the groin

Pain in the anterior thigh

Test Results

Radiograph: Shows decreased bone mass, ossification centers, and possibly

subchondral fracture.

Treatment

Legg-Calvé-Perthes disease is self-limiting.

Physical therapy to restore range of motion.

Administer analgesic to reduce pain.

Nursing Interventions

Perform range-of-motion activities to maintain normal motion of the joint.

Teach the patient how to use crutches.

Explain to the parents and the patient that the disease is self-limiting and

that the patient will fully recover once the disease has run its course.

Talipes (Clubfoot)

What Went Wrong?

A clubfoot is a congenital deformity that occurs in utero due to adverse effects

of medication, infection, trauma, or genetic trait resulting in contracture of

soft tissue and abnormal development of a joint and muscles.

Signs and Symptoms

Usually position or forming of one or both feet

CHAPTER 13/ Musculoskeletal Conditions^295