If your child complains of pain in the leg, it is important to pay attention to this complaint. Perhaps this is Pertes.
Content
The deterioration of blood supply to the thigh head and further aseptic necrosis - this is Pertes's disease. The disease is manifested in children's (teenage) years, more often among boys. Girls are less susceptible to this disease, but the disease itself is harder. There are one -sided and bilateral localization of the disease, and often the joint of the second thigh is less affected.
Symptoms and causes of Pertes
At first, the joint is fixed with weak pains of a stupid character during walking. Sometimes the pain is felt in the knee and even throughout the leg. It is during this period that limitation begins.
With the continuation of the destruction of the bone head, the pain becomes more intense, the lameness is stronger. There is a swelling of the soft tissues, the limitation of mobility in the joint, which makes it difficult to walk. The foot changes qualitatively, it becomes cold, pale, the skin becomes marble. The temperature may rise.
Further, pain subsides, and although the child can already rely on his leg, he can still limp. There are cases when the leg is shortened. In the future, clinical paintings inherent in arthrosis are observed.
![More often manifests itself in boys](http://heaclub.ru/tim/e7c2bec29b59f72c4a2facfbf1b029bd/chashe-proyavlyaetsya-u-malchikov.jpg)
- The reason for Pertes's disease can be the smallest, sometimes unnoticed injury, and not only bruises, dislocation or stretching, but also just an awkward movement.
- Also reason Inflammation of the joint directly against the background of a viral infection may be.
- In adolescence, the cause of the metabolism, a change in hormonal balance can be the cause. A possible reason may be hereditary factors that determine, for example, the features of the structure of bone tissue or joint itself.
- Among the factors that contribute to the disease, doctors call allergies, infectious ailments, rickets, hypotrophy.
According to the observations of doctors, most often Pertes's disease is found among children suffering from myelodispplasia, which is characterized by underdevelopment and less vessels in the thigh head, which entails inferior blood supply to tissues, and due to this, their death.
Percesse disease development process
- Reducing blood flow and the formation of a necrotic area.
- In the damaged area, the bone bone head is transformed in the form of a fracture.
- Then necrotic tissues are absorbed, and the neck of the thigh becomes shorter.
- In the necrotic section, connective tissue grows. It is replaced by a bone, a fracture fuses.
![Stages](http://heaclub.ru/tim/2ede80dfa1e1a6fc49f5a5695da88514/stadii.jpg)
How the disease will end is determined by the size and location of the necrosis zone. If it is small, restoration can be full. In the opposite case, it is possible to stratify the head into several parts, which can lead to its incorrect form when fused. The result may be a severe degree of coxarthrosis.
Diagnosis of Pertes
The history is initially collected, the child examines an orthopedist that determines the amplitude of movements in the joints.
- One of the main methods of diagnosis is x -ray. If it does not make it possible to determine the overall picture at the initial stages of the disease, an ultrasound, computed tomography and a hip MRI are performed.
- In parallel, the frequency of heart contractions is examined, arterial pressure is measured, ECG is removed. Urine and blood tests are also taken to establish the presence of changes in bone metabolic processes.
![We diagnose](http://heaclub.ru/tim/7ac8ce76e88d3e7a46570e6567027739/diagnostiruem.jpg)
Treatment of Pertes's disease
With small changes in the joint, the child is observed by a children's orthopedic . If the symptoms are more expressed, the course of treatment is prescribed in the orthopedics department, after which an outpatient treatment is carried out. In general, the treatment is quite long, occupying from a year to three to four years.
- The course of treatment includes: Absolute leg unloading, carrying out the Kirshner knitting needle through the supra -mushroom area, the use of dressings using gypsum or tires, orthopedic devices and beds with a special design are used for treatment.
- The flow of blood in the joint is regulated by drug. The tone of muscles is also supported and the processes of the growth of connective tissues are stimulated.
- A certain diet is prescribed, including proteins containing calcium products. A specially selected complex of physiotherapy exercises, massage of the peripheral muscles is required. Orally and intramuscularly the introduction of chondroprotectors and angioprotectors (Ibufen, neurofen, etc.), which reduce the processes of inflammation and pain.
- In the course of treatment, mineral baths, mud, diathermy, UHF, electrophoresis sessions, magnetic and laser therapy are also used.
![Treatment](http://heaclub.ru/tim/df47e6f461b70479e5bbdafc0de02bc9/lechenie.jpg)
Surgical treatment is possible after the child is six years old, in the presence of noticeable deformation. The postoperative period includes the above methods of conservative treatment, manual therapy.
Preventive methods in Pertes's disease
In the first months after the course of treatment, you can use crutches so as not to load problem areas.
- It is necessary to avoid increased loads, limit sports.
- A long stay on the legs is not recommended.
- It is necessary to continue to perform the exercises of the medical gymnastics course, to be healed in sanatoriums if possible.
![It is important to exclude loads](http://heaclub.ru/tim/bdefbb918870e71665864ff89900bea0/vazhno-isklyuchit-nagruzki.jpg)
It should be remembered that the sooner the treatment is started, the more effective and more fully recovery. Therefore, at the first complaints of the child about the discomfort in the knee or thigh, with his slightest chromium, it is very important to immediately visit the doctor.