On the Development and Course of Legg-Calvé-Perthes Disease (LCPD)

LCPD necrosis of the epiphysis of the femoral head takes place as a manifestation of disturbance of the blood supply. This is confirmed by histologic evidence and from the reduced uptake of bone-seeking isotopes in the initial stage. During the ensuing revascularization there are indications that vessels penetrate the epiphyseal plate giving rise to temporary bone bridges between the metaphysis and the epiphysis. This is supported by the demonstration of bone projections from the metaphysis into the epiphysis on radiographs and observations in animal experiments. Partial intertrochanteric osteotomies combined with internal fixation as an attempt to promote revascularization have not had any decisive influence on the course of the disease, although reconstitution seems to be enhanced in some cases.