LNSLNS An important cornerstone of conservative treatment of Perthes disease is to reduce the weight placed on the affected hip joint. Strict mechanical unloading of the affected hip joint is not necessary. What is important, however, is that extreme stresses are avoided, which is why we recommended low impact sports.

We recommend the use of crutches only for the short term and during the acute phase. For long term treatment, neither crutches nor weight-bearing orthoses are usually required nor are they sensible. Studies that show the positive therapeutic effects of weight-bearing orthoses are lacking. The main emphasis of conservative treatment is therefore on functional physiotherapeutic treatment.
DOI: 10.3238/arztebl.2010.0062b

Dr. med. Manfred Nelitz
Orthopädie Universität Ulm
Oberer Eselsberg 45
89081 Ulm, Germany
manfred.nelitz@rku.de

Conflict of interest statement
The authors of both contributions declare that no conflict of interest exists according to the guidelines of the International Committee of Medical Journal Editors.
1.
Nelitz M, Lippacher S, Krauspe R, Reichel H: Perthes disease—current principles of diagnosis and treatment [Morbus Perthes – Diagnostische und therapeutische Prinzipien]. Dtsch Arztebl Int 2009; 106: 517–23 VOLLTEXT
1. Nelitz M, Lippacher S, Krauspe R, Reichel H: Perthes disease—current principles of diagnosis and treatment [Morbus Perthes – Diagnostische und therapeutische Prinzipien]. Dtsch Arztebl Int 2009; 106: 517–23 VOLLTEXT