In Legg-Calve-Perthes disease, what should the nurse expect to include in the plan of care?

• A. Initiation of pain control measures, especially at night
• B. Promotion of ambulation despite the child's discomfort
• C. Prevention of flexion in the affected hip and knee
• D. Avoidance of weight bearing on the head of the affected femur

Answer: (D)

In Legg-Calve-Perthes disease, the focus of care is to protect the damaged femoral head while it revascularizes and remodels. The critical goal is to prevent deformity by keeping the femoral head from bearing weight, especially during the healing phase. This containment approach—limiting weight bearing on the affected hip and often using devices or positioning to keep the head centered in the acetabulum—helps the head maintain its shape and improves the chance of proper remodeling as blood flow returns.

Pain control is helpful, but it doesn’t address the risk of head deformation from loading the joint. Encouraging ambulation despite discomfort would add stress to the hip and worsen outcomes. Restricting flexion would not be appropriate because maintaining safe range of motion helps prevent stiffness and contractures. Thus, avoiding weight bearing on the head of the femur best aligns with the goal of protecting the joint during healing.