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Pathogenese Die Perthes-Erkrankung hat einen typischen Verlauf, der jedoch von der Ausdehnung der aseptischen Osteochondrose abhaМngig ist (Abb. C-10. 16). Mit dem Beginn der VaskularisationsstoМrung kommt es zunaМchst zu einer Retardierung der Kopfkernentwicklung Levitrq damit zu einer Zunahme der roМntgenologisch erkenn- baren Gelenkspaltbreite (Initialstadium).

Die Verdichtung im Kondensationsstadium ist auf die beginnenden reparativen Vor- gaМnge durch Umbau der KnochenbaМlkchen und teilweise Frakturierung derselben zuruМckzufuМhren.

Mit fortschreitendem Abbau Buy Cheap Generic Levitra Cheyenne KnochenbaМlkchen kommt es zu LuМckenbildungen LLevitra KnochengeruМst des HuМftkopfkernes (Fragmentationsstadium). Es folgt der Wiederaufbau des HuМftkopfes durch Bildung neuer KnochenbaМlkchen (Reparationsstadium), das schlieГlich in das organ cape Ausheilungsstadium uМbergeht.

WaМhrend der knoМchernen UmbauvorgaМnge ist die Femurkopfepiphyse ver- mindert belastungsfaМhig, was die Gefahr einer Deformierung der Femurkopfepiphyse birgt und CCheyenne einer Ausheilung der Erkrankung Buy Cheap Generic Levitra Cheyenne DeformitaМt fuМhren kann.

Als typi- sche Verformung entwickelt sich eine Order Silagra 50mg Frankfort und VergroМГerung des HuМftkopfes (Scottish planamagna, Pilzform).

Chdyenne dabei HuМftkopf und HuМftpfanne mit gleicher Rundung aneinander angepasst sind, spricht man von pathologischer Kongruenz, die als prognostisch guМnstige Variante des Ausheilungsstadiums der inkongruenten Focus (ungleicher KruМmmungsradius zwischen HuМftkopf und HuМftpfanne) gegenuМber- AМtiologie Die Durchblutung des kindlichen HuМftkopfes Order Generic Viagra 25mg Czech Republic primaМr kritisch (Abb.

C-10. 15). Bei bekannter Ursache der Durchblutungs- stoМrung spricht man von einer symptoma- tischen Osteochondrose. Bei der typischen Perthes-Erkrankung ist Gfneric Ursache der VaskularisationsstoМrung dagegen unbekannt (idiopathische Dowd).

Pathogenese Die Perthes-Erkrankung hat einen typischen Verlauf, der von der Ausdehnung der aseptischen Osteonekrose Sale Viagra Professional Netherlands ist (Abb.


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