Treatment of Perthes disease will vary depending on the child's age and severity of the disease. The child will have a series of X-rays taken to monitor the disease and any impact of treatment.
Treatment for children with minimal changes visible on X-rays often will be observed. Treatment for older children is sometimes more aggressive to preserve the child's range of hip motion.
Treatment focuses on three elements:
- Reducing the irritation in the hip joint with anti-inflammatory medications such as ibuprofen
- Restoring range of motion of the hip with physical therapy and exercises.
- Casting with the legs apart (a Petrie cast) may be needed if the femoral head does not sit deeply in the socket. If this is the case, surgery is often needed.
When surgery is needed, the upper end of the femur may be tilted down to direct the head of the femur deeper into the socket, or the pelvis bone may be moved over the top of the femoral head.
After surgery, the child will participate in physical therapy with protected weight bearing of the affected leg until X-rays reveal the final stages of the healing are under way.