Does osteotomy treat Perthes disease?

Perthes disease affects the developing ball of the child’s hip joint. The shape and flexibility of the femoral head can change during the condition, so treatment aims to keep the ball well positioned within the socket and preserve useful hip movement. An osteotomy changes the angle or position of a nearby bone to help achieve that containment.

It is not needed for every child. Age, hip movement, the shape and position of the femoral head, disease stage and expected growth all influence the plan. Some children are managed with observation, activity changes, physiotherapy or other measures, with repeated clinical and imaging checks.

Seek assessment from a paediatric orthopaedic team if a child has persistent hip or groin pain, a limp, limited hip movement or pain referred to the knee. Keep appointments for examination and imaging, and follow advice about impact activities or protected movement.

Before an osteotomy, ask how the procedure supports the hip, what fixation is used, and how long crutches, a cast or restricted activities may be needed. Rehabilitation focuses on safe hip movement, strength and returning gradually to age-appropriate activity.

Prompt review is needed for a new or worsening limp, persistent night pain, fever with hip pain, or refusal to walk. After surgery, urgent assessment is appropriate for uncontrolled pain, a swollen or numb leg, wound drainage, fever or breathing difficulty.

How well is the femoral head contained, and what does the imaging show about its shape? Could non-surgical care meet the goal? If osteotomy is advised, what restrictions, equipment and rehabilitation will my child need?