Brad (update)

[tracey]

I wrote about my son Brad a few weeks ago. We were hoping his prognosis would be good because he wasn't complaining about pain and his range of motion/limp seemed to be better.

When we went back to the doctor yesterday we realized those outward signs really have nothing to do with what's going on inside. His hip is starting to protrude from the socket, it is flattening out, and his is classified as a b/c Herring classification. So our doc is recommending the femoral osteonomy surgery.

I was quite surprised because this was only our second visit and I had gotten the impression that he would be monitoring him for a while longer before making a recommendation about surgery. So I'm now doing my research about this form of treatment before we say yes. Any thoughts? I think because Brad was doing so well I was hoping he would grow out of this without intrusive treatment but I guess I was deluding myself.

[Donna Brown]

I'm so sorry to hear that Brad's hip isn't as good as it appeared. Unfortunately, until you see the xrays, quite often you have no idea whatsoever, of how bad things are.

Surgeries like the femoral osteotomy have a proven track record. The only bad thing that can come of it, is that longterm it can affect the childs leg length and may need to be reversed at a later stage. This is definitely something that you may want to chat with the surgeon about. Having said that, its a good surgery that does achieve good containment of the femoral head. The alternatives to this are a pelvic osteotomy, shelf procedure or external fixator (but only if you can access a doctor trained to do this and there aren't a lot of them).

My guess would be that your surgeon has had some great success using the femoral osteotomy on previous perthes children and that experience is also definitely something you should look at, as its invaluable when you are putting your child in their hands.

You need to look at what your options are, what feels right for your family and what you think Brad would cope the best with and make a decision that way, as we all have our own tolerances of different situations and no-one can tell you what is right for you. I hated being in this situation myself, but educating myself as much as I could at the time, taking advantage of the fact that our surgeon had a lot of experience with perthes kids and was able to give me confident answers on the outcome, made a huge difference in me trusting that it was the right decision to make.

All the best

Donna - NZ