Posted by Lynne Oldham on January 20, 2004 at 11:10:23:
In Reply to: wait & see vs. surgery posted by Dana on January 14, 2004 at 20:37:28:
: My 4 yr. old son was diagnosed w/ Perthes in December and the orthopedist put him on "light" activity for two months to see if the deterioration progresses or stops. If it doesn't help and the bone has deteriorated more, he suggests surgery including "building a shelf" on the hip to protect the joint until blood flow is restored. Has anyone experienced this surgery? success?
Hi. Our son was diagnosed with unilateral Perthes also at age 4. He is now 5 1/2 and just had surgery. He had a triple pelvic osteotemy and is in a hip spica cast for another two weeks. After the cast comes off, he will be a wheelchair for an additional 4 weeks and then can return to his "normal" activities, although we still have to hold off on the sports until regrowth occurs. We opted for surgery because over the wait and see period, the top of femur began to flatten out over the socket. Our doctors told us that the surgery would contain the area so that when regrowth occurs, it will occur in the right place. Our son's Perthes is unusually bad given his young age and this is why we went the surgery route. It is true that the majority of children under 5 do just fine without surgery/treatment. Just keep an eye on it and follow up every three months. If the doctors suggest surgery at some point in the future, I would also recommend getting second and third opinions.
Our doctor told us that the shelf procedure you mentioned is more a salvage type of surgery and is more often performed on older kids.
Best of luck to you. You can e-mail me directly if you have any more questions.