Many things have changed in the past few decades. Would anyone coming of age now even recognize a rotary phone? Perthes treatment is no different. While the focus is still on containment and maintaining range of motion, the tools of the trade have changed with the times.
Decades ago a patient might expect to spend months in the hospital and in traction followed by months of bracing and weight bearing activity restriction. Casts and braces were heavy and unwieldy. Today weight bearing activity restriction is still crucial. Casting as well as bracing is still employed although the casts and braces are state of the art and lighter than ever! There are adaptive equipment choices, such as wheelchairs and crutches, that weren’t available to generations prior.
X rays were and still are a mainstay of treatment however today the imaging performed uses a much lower dose of radiation and is safer. Ultrasound and MRI are also used as an alternative to ionizing radiation and have the ability to offer surgeons a “functional” look at the dynamics of blood flow and range of motion of the hip joint.
What is on the horizon? New surgical techniques are always being evaluated. Some surgeons are suggesting immobilization using Botox injections. Others are pioneering pharmaceutical treatments. As progress continues we have to ask, “What will the standard of Perthes care be for the next generation?”