Femoral head osteonecrosis (FHO) can affect children and adults. While there are similarities between childhood and adult FHO, the differences in the epidemiology, pathology, pathophysiology, pathogenesis of deformity, the natural history, and the outcomes of the childhood and adult FHO are notable. This chapter will focus on the pathology, pathophysiology, and the pathogenesis of femoral head deformity in Legg-Calve-Perthes disease (LCPD). Furthermore, the differences between childhood and adult FHO will be discussed. A discussion on the differences between the internal structure of the skeletally immature femoral head and the mature femoral head is useful in understanding the differences between childhood and adult FHO.
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