Introduction: Legg-Calvé-Perthes disease (LCPD) is a self-limiting pediatric hip disorder that can leave femoral head deformity and impaired hip function. Conservative treatment remains an important option, particularly in younger children and less severe disease. This study evaluated functional outcomes after conservative management at a tertiary pediatric orthopedic center in Nepal and explored demographic and clinical factors associated with outcome.

Methods: This cross-sectional analytical study included 30 children with LCPD who completed conservative management at the Hospital and Rehabilitation Centre for Disabled Children (HRDC), Banepa, Nepal, between January 2010 and December 2024. Functional outcome at the latest follow-up was assessed using the Harris Hip Score (HHS), categorized as <80 or ≥80. Associations with age group, sex, laterality, and follow-up duration were assessed using Pearson chi-square or Fisher exact tests, with p < 0.05 considered significant.

Results: Twenty-one participants (70.0%) achieved HHS ≥80. The cohort was predominantly male (23/30, 76.7%); 16 (53.3%) were younger than 10 years, and left-sided disease was most frequent (17/30, 56.7%). No demographic or follow-up variable was statistically significantly associated with functional outcome after exact testing. Sex showed a borderline association: all seven female participants achieved HHS ≥80 compared with 60.9% of males (Fisher exact p = 0.058). Age group, laterality, and follow-up duration were not significantly associated with outcome.

Conclusion: In this Nepalese tertiary-center cohort, conservative management was associated with good-to-excellent functional outcome in 70% of children. No factor was definitively associated with outcome; the borderline sex finding should be interpreted cautiously because of the small female subgroup. Prospective studies incorporating radiographic severity and pediatric-specific outcome measures are needed.

Keywords: Avascular necrosis, Conservative management, Harris Hip Score, Legg-Calvé-Perthes disease, Pediatric orthopedics.