Indicators of severe functional restriction

Any child undergoing active treatment for their disease may have mobility or care needs. These may or may not persist for more than 6 months. Children with bilateral disease where both hips are affected are more likely to have care or mobility needs persisting beyond 6 months. This is because the disease often occurs sequentially i.e. the second hip is affected some time later and the total duration of treatment is longer.

Any of the following treatments may affect care and mobility needs -:

• Broomstick plaster – children will be unable to walk in these. May also require help with mobilising to the toilet and dressing.
• Hip Spica – child will be unable to walk in this. May also require help with mobilising to the toilet and dressing.
• Surgery – osteotomy – there will be a period after surgery when the child will be unable to weight bear on the operated hip, younger children are likely to spend the healing period in a hip spica and older children will mobilise on crutches. Normal walking would be expected by the majority of children at six months after surgery.
• Arthrodiastasis – children with an external fixator will be mobile. Their parent or carer will need to clean the pin sites daily and monitor them for signs of infection. Children will need help and supervision with washing and dressing.
• Orthotic brace – all children with a brace will require help with washing and dressing as the parent will need to put on and take off the brace for them whenever necessary. The child may or not be able to walk independently in the brace.