Partial or complete necrosis of the femoral head epiphysis due to impaired blood flow to the femoral head is called pediatric ischemic necrosis of the femoral head, also known as Legg-Calve-Perthes disease, or Perthes disease. After necrosis, the femoral head is often left with a flat deformity, called flat hip. In our long-term practice, we found that most children can get good results through conservative rehabilitation treatment.
(A) Treatment principles.
1.Prohibit weight-bearing to avoid femoral head collapse; (not absolute)
2.Improve the head socket inclusion, facilitate femoral head shaping, and prevent or reduce the deformation of the femoral head; (surgical improvement, but it is still debatable)
3.Improve the blood supply of the femoral head. (Oral proprietary Chinese medicine)
(II) Abduction support and traction
1, lower limb holster traction (needed for individual children)
2.Adductor brace with cast fixation (commonly used)
(C) surgical treatment
1.Synovectomy (such surgery is no longer performed)
2, inter-rotor osteotomy (affects the bone and joint structure and has an impact on the child in the future)
3, vascular bundle implantation (no basis)
4, drilling decompression (no obvious effect)
(D) pediatric femoral head necrosis exercise therapy: (whether conservative or surgical treatment is very important)
I. Joint grinding construction
Abduction plastic exercise therapy.
(1) split-legged kneeling grinding (no muscle tension): a front and a back, rich rhythm
(2) abduction straight leg elevation (muscle tension): flat up and down, uniform movement
(3) prone straight leg abduction lift (muscle tension): flat up and down, uniform movement
Second, stretching loose bones
1, kneeling leg press: step by step, good posture
2.Vajra sitting: step by step, good posture
Three, muscle training
1.Bedside kick (quadriceps)
2.Leaning back leg lift (iliopsoas muscle)
Note: This method is characterized by the use of some special posture, clever biomechanical principles, to promote the joy of patient exercise. And a combination of Chinese medicine “Yi Jin Jing”, yoga and other concepts with which has far-reaching significance, the patient persistently, benefit greatly.