Perthes disease in 20 yr old girl

X-Ray of a 20 yr old girl

Reshmi (name not revealed as per request of patient) came with a complain of inability to abduct her hip beyond 30 degrees. Flexion  of hip possible till the range of 50 degrees.This girl was put on cast post trauma to the pelvic region. X-ray reveals reduced space between acetabulum 

and femur head. Avascular necrosis of articular surface.

Now my question - 

1. Age has not come to take her for any surgical management ( like THR)  so what  should a physio aim at?

 2. With time disuse atrophy can occur around hip muscles. so what should be the  PT management

 3. Psychological factors need to be considered. What is PT role in that & how?

 4. what shd be the short term and long term goal

Conclusion: 

Our management must be a sum up of all this . This helps you set up your own protocol, no need of any book