Introduction Legg-Calvé-Perthes' disease is an idiopathic avascular necrosis of the femoral head that arises in childhood. There have been many theories on its aetiology, which include the role of genetic factors, environmental factors, poverty, repetitive trauma and abnormalities of thrombosis and fibrinolysis. Recent theories on the aetiology of Perthes' disease have focused on passive smoking as a risk factor. Previous studies in southwest India have determined that the prevalence of Perthes' disease is very high. The prevalence of tobacco use in the area is not higher than in other regions of the country. Based on these observations, the association between passive smoking and Perthes' disease was re-examined.
Methods Cases were children aged <12 years at diagnosis of Perthes' disease. Children presenting to the hospital for other orthopaedic complaints formed the controls. The 128 eligible cases were frequency matched on age and sex with controls, with 3 controls per case. Conditional logistic regression was employed to evaluate the association between the exposures and risk of Perthes' disease.
Results Risk factors for Perthes' disease were having a family member who smokes indoors (adjusted OR 2.07) and indoor use of a wood stove (adjusted OR 2.56).
Conclusion This study adds further evidence for the association between tobacco smoke and Perthes' disease. For the first time the association between wood smoke and Perthes' has been demonstrated.
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