Changes in the capital growth plate and the proximal femoral metaphysis in Legg-Calvé-Perthes disease.

Studies on about 350 hips treated during the years from 1946 to 1965 for Legg-Calvé-Perthes disease (LCPD) showed that metaphyseal changes regularly appear in this condition. When these changes are extreme, a step-like irregularity appears in the capital growth plate and the bony epiphysis adapts itself to the metaphyseal defect. This phenomenon of step-like progression of changes in the growth plate is seen in other conditions as a consequence of cartilage necrosis. When premature closure of the capital epiphyseal plate occurs in LCPD it may be followed by "overgrowth" of the greater trochanter and a positive Trendelenburg sign. This functional disability may be prevented by apophyseodesis of the greater trochanter if it is performed early enough.