STI Global CityGlobal City, Taguig

Legg-Perthes Disease

PHILIPPINE ORTHOPEDIC CENTERJOSEPHINE C. TAGALOG

III-BSN 601 Group 1

Reporters Profile

• Name: Josephine Cortez Tagalog• N-Name: josh,bunny,tagy• Add: east rembo makati• Contact No.# 09196924674• Email add: FS: jorshbunny@yahoo.com• joshphen666@yahoo.com• Yr/Section: IV-701• School: STI Global City

INTRODUCTION

• Legg Calve Perthes Disease is a gradual weakening of the upper end of the thigh bone at the junction where it meets the pelvis. The right or left hip joint can be involved, and occasionally both are included.

• It normally afflicts white Caucasian children in the age bracket of 3 to 12 years, with a ratio of 4 boys for every 1 girl that is diagnosed with it. It can be found in boy’s age 4 to 8 years that have a delayed skeletal maturity.

DEFINITION

• Also known as: Perthes disease, Coxa

Plana, ischemic necrosis of the hip, osteochondritis

• Necrosis of the head f the femur (thigh bone) due to interruption of its blood supply.

SIGN AND SYMPTOMS• Hip or groin pain, which may be referred to the

thigh.• Mild or intermittent pain in anterior thigh or knee.• Limp • Usually no history of trauma• Decreased range of motion (ROM), particularly

with internal rotation and abduction • Atrophy of thigh muscles secondary to disuse • Muscle spasm • Leg length inequality due to collapse

DIAGNOSIS MEDICAL DIAGNOSIS• ·      transient synovitis• ·      acute phase of bacterial infections of hip joint• ·      septic arthritis• ·      osteomyelitis• ·      Gaucher's disease• ·      sickle cell disease• ·      epiphyseal dysphasia• ·      a vascular necrosis secondary to trauma

NURSING DIAGNOSIS• Impaired physical mobility related to positioning, weight

bearing, and activity restrictions after hip replacement• Hemorrhage; neurovascular compromise; dislocation of

prosthesis; deep vein thrombosis; infection related to surgery

Diagnosis….. Cont.

• Diagnosis is made predominantly by X-ray study, together with physical examination (MRIs have also been found useful for judging the extent of the deformity). Sufferers typically have limited range of motion in their hip, particularly when rotating the joint.

PATHOPHYSIOLOGYGenetic Factors,

Hormonal Factors, Sometimes Unknown

Juvenile idiopathic(a vascular necrosis

of femoral head)

Decrease of blood flow coming from the long bone to the part of the acetabulum and the head of the femur

Tenderness of the bone leading to some fracture

Sagging, dislocation ofthe femur

due to decrease synovial fluid

OSTEOCHONDRITIS

TREATMENT• Rest in bed- on the affected part by traction,

cast.• High fluid intake dietary fiber, food rich in

calcium, multivitamins• Drug therapy- multi vitamins, antibiotics,anti

inflammatory• Operative treatment Hip replacement• Nonsurgical containment allows the femoral

head to stay within the acetabulum, where it can be molded. Various casts, braces, and crutches have been used for containment.

NURSING MANAGEMENT• Records the vital sign• Relief the pain• Nutrition• Absent of complication• Express self esteem• Preventing for some complication due to hip

replacement• Preventing deep vein thrombosis• Monitor the wound care and wound drainage• Preventing dislocation of the hip prosthesis• Promoting home and community based care