Preoperative Russell traction in Legg-Calvé-Perthes disease.

Divergent opinions about the pathophysiology and the optimal time and methods for the treatment of Legg-Calvé-Perthes (LCP) disease exist. Synovitis causing restriction of hip motions may be hazardous to the circulation to the femoral head. We studied 23 children (24 hips) in the initial phase of LCP disease. Seven to 14 days of Russell traction decreased the intraosseous pressure significantly (p less than 0.001) and increased the hip motion a mean of 33.6 degrees. As assessed by osteovenography, the venous congestion decreased in almost every hip during Russell traction.