• Is a disease when the head of the thighbone (femur) in one hip deteriorates due to insufficient blood supply to the area.
• Most frequently affects boys 4 to 10 ears old.

Etiology

• The blood flow of the femur is interrupted, and the tip of the bone dies over a period of one to three weeks.
• The disorder causes a flattening of the top of the femur (the ball of the head of the femur).
• Usually one hip is affected, although it’s possible for both to develop the condition.
• The disorder may reflect subtle disorders of blood clothing.

Pathophysiology

• Cause of LPD is insufficient blood supply to the femoral head.
• Epiphyseal plate and the ligamentum vessels become nonfunctional.
• Resulting in flattening and collapse of the femoral head.
• Osteonecrosis

Signs and Symptoms

1. Knee pain
2. Persistent thigh or groin pain
3. Atrophy of muscles in the upper thigh
4. Slight shortening of the leg, or legs of unequal length.
5. Hip stiffness restricting movement in the hip.
6. Difficulty walking, walking with limp
7. Limited range of motion
8. Limited abduction and internal rotation of the hip.
9. Mild to moderate muscle spasm.
10. Deformity and flattening of femoral head
11. Lateral overgrowth of the femoral head cartilage.
12. Progressive loss of movement
13. Abduction contractures

Assessment

1. Physical examination
2. Arthrography
3. Venography
4. MRI
5. CT scan
6. Ultrasound
7. Hip X-ray

Nursing Diagnosis

1. Pain
2. Anxiety
3. Fear
4. Impaired physical mobility
5. Activity intolerance
6. Ineffective role performance
7. Low self-esteem
8. Social isolation
9. Trauma

Nursing Interventions

1. Evaluate home and provide guidance to the family regarding the childs home care.
2. Encourage family participation to the child’s care so that members can become familiar with details of its management.
3. Enable the child to participate as many normal activities of life as possible.
4. Plans must be made for continuing education.
5. Provide diversional activities.
6. Play should include exercise for involved extremities.
7. Special activities with peers should be arranged.
8. Provide emotional support to the child and his family because of the long term mature of illness.
9. Provide the family with frequent opportunities to express their feeling.
10. Point out even small indications for recovery process.
11. Encourage range of motion exercises.
12. Provide bed rest to conserve energy.

Complications

• Osteoarthritis
• Hypothyroidism
• Sickle cell anemia
• Septic arthritis