One of the most common and increasingly common in recent years, orthopedic problems in children is Perthes' disease. This disease of the hip joint and femur, which is associated with a violation of feeding articular cartilage and impaired blood supply to the head of the femur, followed by necrosis. Among osteochondropathies of bone, Perthes' disease belongs to up to 1.9%, and among joint diseases - 25%.
Most often, the disease is diagnosed in male children aged 3 to 14 years. It takes quite a long time - from 3 to 5 years. There are possible consequences of Perthes' disease, such as severe deformation of the head of the femur bone (occurs in 20-25% of child patients), and in the future - development of deforming coxarthrosis, which can cause early disability.
Causes of Perthes disease
To date, there are no known clear causes of Perthes' disease. But among the putative reasons, doctors call the following:
- injuries;
- colds;
- excessive stress on the joints, especially if the child's body is weakened;
- metabolic disease;
- congenital dislocation (very rare case);
- hereditary factor.
Symptoms of Perthes disease
The earliest symptoms are pain and lameness, which are aggravated by walking and prolonged standing. At night the pain disappears, the motion at rest is not very painful. The sick child experiences the greatest discomfort from taking away and rotating the thigh. In the latter stages, Perthes's disease may be accompanied by a shortening of the limb.
The most informative is radiation diagnosis, ultrasound and radiography of the hip (knee) joints. As a rule, only one of the joints is affected, most often the right one.
Treatment for Perthes disease in children
The main principle of treatment is the improvement of blood supply and rest for the affected area of the bone. In order to avoid deformation of the femoral head, the child is assigned a bed rest, and also the stretching of the sore leg. Over time, walking on crutches is permitted using orthopedic shoes. It is recommended to massage from the first days of treatment.
Children suffering from Perthes' disease, many parents are treated in specialized sanatoriums, where all conditions are created for this purpose and there are medical personnel of the appropriate profile.
Massage with Perthes disease
Massage is actively used in the complex treatment of Perthes disease. Its goal is to improve blood circulation and lymph circulation, relieve pain, prevent atrophy of muscles, accelerate the processes of regeneration of bone tissue and restore the motor functions of the joint.
Massaging requires the lumbosacral region, hip joints, buttocks, hips and lower legs. If traction is used, only the last three areas of the diseased leg are available for massage. Therefore, a healthy leg is actively massaged, and the leg on the stretch is only subjected to an easy massage.
In the massage of a diseased leg, the movements are applied in the following sequence:
- Bracing stroking.
- Rubbing 4 fingers in a spiral.
- Embracing non-intermittent stroking.
- Simple non-intermittent or intermittent transverse kneading.
- Again embracing non-intermittent stroking.
The patient's leg should be tried to handle from all sides. In addition, it is useful to massage the area around a large spit and spit itself, using a spiral grinding technique with 4 fingers.
After the gypsum or extension is removed, the need to massage a healthy leg disappears. It is better to focus on the lumbosacral and gluteal regions, as well as on the hip joint.