Femoral head necrosis in children – Frequently Asked Questions and Answers

Q: Why do children get diseases? How can it be cured? Can it be cured? How long will it take to heal? Will there be roots in the future? Can I still play blue ball? A: There are many hypotheses of unknown etiology, the mainstream accepted concept is inclusion (surgical or non-surgical), self-healing disease mainly lies in the spherical repair, the course of the disease is generally 2-4 years, the impact on the future depends on the spherical degree of repair. The repaired hip joint does not affect sports Q: Our family does not have this disease, how can the child get A: There is no evidence that it is genetic, and there is no evidence that it is caused by improper care Q: We do not want to operate, can we conservatively hope to treat A: Traditional for the choice of surgery is generally through: the age of onset (very important), the height of the lateral column, the degree of involvement of the femoral head, the degree of protrusion for a comprehensive judgment; recent international multi The recent international multi-center research results include early intensive nuclear magnetic measurement of the blood supply of the femoral head as one of the bases for surgery, thus avoiding the poor prognosis of late surgery. A: There are no effective clinical drugs available, and it has not been proved that Chinese medicine has any beneficial effect but will produce liver and kidney toxicity; the problem that can be solved by eating is not a problem Q: What exercises should we do to promote repair A: Weightlessness should be the main focus before repair Q: Many parents and doctors say that they can let their children swim, ride bicycles and lift their legs more. A: These exercises are only used to restore muscle strength and recover the atrophied muscles, and have no special effect on femoral head necrosis. Necrosis phase: the femoral head bone modulus is reduced and resistance to mechanical stress is reduced. Fragmentation phase: the femoral head is fragmented and new blood vessels grow in, but no new bone is formed. Repair phase: new bone formation and shaping with stress. A: Disuse atrophy can be recovered soon after going down Q: What should be done if the child has limited hip movement A: Limited hip movement can be improved by Petrie plaster Q: Many children have had their adductor muscle cut due to limited abduction, is this necessary? resection. The restriction of abduction before the repair period of femoral head necrosis is mostly due to inflammatory muscle spasm and synovial swelling, which will gradually improve later. A: Traction can reduce intra-articular pressure and reduce the possibility of deformity, but long-term traction is needed to have a greater psychological impact on the child [16] Q: If conservative, what methods are used A: Plaster pants, abduction brace, abduction without weight-bearing, etc. Q: What is the better method of surgery A: Pelvic osteotomy is better under 6 years of age, and there is no significant difference between pelvic osteotomy and femoral osteotomy above 6 years of age. Currently popular triple osteotomy but not all children need to cut three cuts, many children can achieve good inclusion with one or two cuts Q: Will the child after surgery will appear long and short legs A: normal human lower extremities are not equal in the range of 0-2cm, after surgery will not affect the movement of short and long legs Q: Can the doctor help us consult A: Yes