Legg-Calve-Perthes disease (LCPD) is a disorder of the upper part of the thighbone (head of the femur) that causes breakdown of the head of the femur. This is followed by new bone formation.
LCPD develops because of loss of blood flow to the head of the femur. This causes breakdown (avascular necrosis) and deformity of the femur where it connects with the hip socket. The bone reforms in the hip area when the blood supply returns to normal. During this time, the femur is soft and may easily fracture and collapse. The head of the femur heals in an abnormal shape and does not fit properly into the hip socket, causing stiffness and pain.
The cause of LCPD is unknown. It is seen most frequently in children between the ages of 3 and 12. Boys are affected about 4 to 5 times as often as girls. Usually only one hip is affected, although it is possible to have LCPD in both hips.
Symptoms include pain, limping or an uneven gait, decreased movement, loss of height, and loss of muscle mass in the thigh. Treatment depends on the severity of symptoms but may include physical therapy, a brace or cast, or surgery. Occasionally the disease heals on its own without treatment.
Brendon has been on crutches since November and the doctors have been watching him closley to decide what treatment would be best for him. They had to wait for the bone to stop deteriating before they could start to help fix it. Well, they finally decided it was done going bad, so here is my sister in laws words on what they ended up doing a few weeks ago...
Brendon was scheduled for a major surgery where they were going to cut his femur bone below the hip socket, turn it towards the socket and put a metal plate & screws to hold it together. This was the "sure" way of getting Brendon's femur "securely in the socket". He was in good spirits and ready to go at time of surgery- (I was amazed how brave and calm he seemed-- definitely more than mom!) The surgeon first injected a dye into Brendon's leg to get a better idea what the cartilage around the bone looked like. To his amazement and our surprise- he called the waiting room and reported "the cartilage looks excellent and I think cutting the bone is unnecessary at this time!" He then told us they would cut some tendons in his leg to be able to rotate the leg farther out and then cast his legs. We felt an indescribable relief at that moment- so many prayers were answered.
The reason for casting is two fold: 1. to get the the top of the bone securely in the socket during (or before) re-ossification (new bone growth) which hopefully will encourage the new ball to grow back in a better shape. and 2. to stimulate a better range of motion in the leg after the cast comes off. He could barely move his leg 10-15 degrees to the side because of tightened tendons and muscles around the diseased bone.
We are hoping a praying that when the casts come off that his bone will grow in the right place and he will be a normal 10 year old boy again! I just got these fun pictures of him today... I can't believe he has figured out how to move around with these huge casts on his legs! I've been worried about how bored he must be, but it looks like he is staying busy and happy!
Way to go Brendon! We can't wait to see you at Thanksgiving!
3 comments:
Even though Jared doesn't have this disease, it sounds very like what the ifection did to his bone. The doctor talked to us about this very kind of surgery. It may be what helps him until his growth plates close and he can get a hip replacement. I am glad things are working out for your nephew. Who knew such things existed to worry about each night.
What an inspiring story! Your nephew looks happy even though he's in those casts. Prayer works miracles and holding off on that major surgery was definitely one!
that poor little guy! nightmare cast...holy cow! and yet he's wearing a smile in all the pics. amazing! hope all turns out well.
Post a Comment