Abstract
Perthes' disease is a serious illness of the hip joint in childhood, which may indeed heal itself (self-healing), however, without the correct therapy, mostly at the price of the occurrance of early arthrosis of the hip joint. Groin pain is typical for the beginning of the disease, but it may be completely missing; there could be a thigh or a knee pain, sometimes we find only limp without pain.
For the correct determination of the diagnosis x-ray of both hip joints in two projections (anteroposterior and "axial") is essential, then for the monitoring of the development of the disease an anteroposterior x-ray is sufficient. Except for the rest regime and rehabilitation care the abduction orthesis Atlanta is most often used in the conservative treatment, we decide for surgical treatment in case of head at risk.
Early surgical treatment as well as conservative treatment comes from the principle of "containment", then we carry out innominate osteotomy, respectively varus femoral osteotomy. Late surgical treatment then includes abduction-rotational femoral osteotomy, alternatively cheilotomy - shaping of the femoral head.