10 yr. old girl with Perthes

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My 10 yr. old granddaughter was recently diagnosed with Perthes.  The first Dr. at Children's Hospital is recommending a wait and see approach (limit weight bearing, swimming, & using her crutches if in pain).  The second Dr. at Shriners says if we want to do surgery (femoral varus osteotomy) to contain the femoral head, he wants to do it within the next three weeks.  Since she is a girl and they seem to have a poorer prognosis and because she is 10, we are leaning toward the surgery.  Anyone out there in a similar situation?  Or who has had this surgery and what was the outcome?

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  • Posted

    Hi Judi

    If your daughter was under 7 years old, then a wait and see approach could work and her body would do all that was needed to repair the damage.  However at 10 years old, and also being a girl (as the specialist has mentioned), means that she is on the older end of diagnosis, which means that surgery is generally the better option for a good long term outcome.

    The thing with being a girl is that the growth plates in girls close earlier than they do for boys, so that is why this fact is significant.  With osteotomies there is a 'window of time' where these surgeries are effective and your specialist obviously feels this time is now.

    Shriners are well experienced in dealing with children and good at doing surgeries like the osteotomies for perthes kids

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    • Posted

      Thank you Donna for the feedback.  Her dad is leaning toward surgery.  We just want to do the right thing, and it is so hard to figure out what that is when you're dealing with this condition.

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    • Posted

      When the growth plates start to close, the body us running out of time to repair the damage. For a girl growth stops around 14.5 years or 18 months after menstruation starts (that is a generalisation). Whereas for boys this happens later.

      This is why, for a girl of 10 years old, surgery is something you really need to be considering because you really done have the luxury of time to do a wait and see approach.

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    • Posted

      Was there a link you sent with this that has been removed?  That I could see thru private messaging?  And thank you again for your help.  We are getting prepared for surgery.

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    • Posted

      There was and it definitely wasn't unsuitable, as it's an information site that would be useful. Search for the words kiwigypsynz and perthes and you should find the site. It's a wix site and there is a full medical glossary on there, as well as information about what is happening and why, as well as a basic overview of treatment options
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