[Spontaneous necrosis of the upper femoral epiphysis in prepuberty (puberty "Perthes")].

The author differentiates between prepubertal necrosis of the upper femoral epiphysis and Perthes' disease in children. A number of clinical and roentgenological factors are decisive in distinguishing between the two conditions. Prepubertal epiphysial necrosis is always quickly followed by severe hip deformity which, in contrast to Perthes' disease, cannot be corrected by any therapeutical means. Early osteoarthritis must be expected in all cases. The author discusses several therapeutic possibilities which have not yet been tested and which, in case which are diagnosed early, could have a positive effect.