Bracing for Perthes disease: what families should know

The orthopaedic team bases the decision on the child's hip shape, movement, symptoms and stage of the condition. Follow-up is needed to check the hip and adjust the plan as it changes.

Perthes disease temporarily disrupts blood supply to the developing femoral head, the ball at the top of the thigh bone. The bone becomes vulnerable while it breaks down and rebuilds. Some braces hold the hips apart so the femoral head remains well seated within the socket, an approach called containment. A brace does not restore blood flow or instantly reshape the bone. Its usefulness depends on whether useful hip motion remains and whether the child can follow the prescribed wearing plan.

Use the brace for the schedule and activities specified by the treating team, because designs and goals differ. Check the skin at contact points and report rubbing, blisters or pressure marks that do not settle after removing the device. Keep straps secure but not so tight that the feet become cold, discoloured, swollen or numb. Attend fitting and imaging appointments even when the child feels well. Paediatric physiotherapy may support hip motion, muscle function and practical movement at home or school without working against the containment plan.

Contact the orthopaedic team if the brace no longer fits, breaks, causes skin injury or cannot be worn as directed. A worsening limp, increasing groin, thigh or knee pain, or a clear loss of hip movement also deserves review. Seek urgent help if the foot becomes persistently cold, pale or blue, sensation changes, severe pain appears suddenly, or the child has fever with a hot, swollen joint and seems unwell.

Ask what the brace is intended to achieve for this child's hip, how wear will fit around bathing, sleep and school, and which activities remain appropriate. Clarify how skin and circulation should be checked, who to call for fit problems, and how progress will be monitored. It is also reasonable to ask what would lead to a change in treatment and when an operation such as osteotomy might be considered instead of, or after, non-surgical care.