Medical Hydrology and Balneology: Environmental Aspects

Chondrogenic effect of the sulphuric peloid
from banja koviljaca in remodeling of the
femoral head in children with M.Perthes
Stojkovic N (1) , Jevtic N (1) , Sremcevic N (1) , Abramovic D (2)
(1) Hospital, Banja Koviljaca, Serbia
(2) The Children's University Clinic, Belgrade, Serbia.
lekari@banjakoviljaca.rs
Introduction and Objectives
Perthes disease is characterized by osteonecrosis of the femoral head in a child
in development. The disease may affect epiphyseal plate and metephysis, resulting
in the secondary changes of acetabulum. It occurs at the age of 3-12, more often in
boys, and the most possible cause is generalized disorder of the skeletal maturity.
The objective of this study was to present chondrogenic effect of the sulphuric
peloid from Banja Koviljaca in remodeling of the femoral head in children with
M.Perthes in during the 22 years time period of observation.
Materials and Methods
In the time period between 1989 and 2011, at the Children's Department of the
Specialized Rehabilitation Hospital, 1136 children were treated after being operated
on for Morbus Perthes. There were 892 boys and 244 girls. Most children were
operated on for M.Perthes, and 8 children had bilateral M.Perthes, Catterall groups
3 et 4. The sulphuric from Banja Koviljaca was applied in all children admitted for
the physical treatment, and paraffin was applied in the control group, where application
of peloid was contraindicated (sma, traum. paraplegia, myotonia) 12 in total.
Results
After physical treatment. Most children (1104) were allowed to gradually lean
on the operated leg completely. The motion range was increased in all directions to
full. The circumference of the limbs was increased for 2.5 cm on average in comparison
to the healthy leg. The muscle strength according to MMT was increased to
the score being 4 to 4+ on average. The radiology report indicated remodeling of
the femoral head cartilage, and the sites of osteotomy completely healed up.
Conclusions
Application of the sulphuric peloid in M.Perthes has significant chondrogenic
effect in remodeling of the femoral head, being observed empirically, because it is
very complicated for proving it »in vivo«. The treatment should be started immediately
after the surgical treatment. The treatment has to be long enough in order to
achieve remodeling of the femoral head. Remodeling of the femoral head was not
Balnea
2012, núm. 6, 181-182
181
ISBN: 978-84-669-1887-0
978-84-669-3482-4