Secondary avascular necrosis after treatment for congenital dislocation of the hip

J Pediatr Orthop B. 1995;4(2):188-93. doi: 10.1097/01202412-199504020-00011.

Abstract

We made a radiographic study of 104 unilateral congenital dislocations of the hip (CDH) that had an average age of 12 months (range 4-24), were treated with the same therapeutic protocol, and had an average six years follow-up (range 3-13). Radiographic changes were evident in the proximal femoral epiphysis in 57 hips (55%). In 7 (7%) the changes consisted of central osteoporosis with a cystic aspect, without metaphyseal or physeal changes, and had a normal end result without sequelae. This group was classified as type I. Fifty hips (48%) that were type II showed epiphyseal changes consisting of trabecular rarefaction with osteoporosis and irregular sclerosis, followed by a decrease of epiphyseal height and trabecular recovery. Forty-two hips (40%) were type IIA, with < 75% decrease in epiphyseal height with respect to the healthy side; five of these had a normal evolution, 35 had coxa magna and/or decrease of epiphyseal height, and only two cases had physeal lesion. In type IIB, hips, with > 75% decrease of epiphyseal height, 8 cases (8%) had a final physeal lesion.

MeSH terms

  • Child
  • Child, Preschool
  • Female
  • Femur Head Necrosis / diagnostic imaging
  • Femur Head Necrosis / etiology*
  • Hip Dislocation, Congenital / complications*
  • Hip Dislocation, Congenital / diagnostic imaging
  • Hip Dislocation, Congenital / therapy*
  • Humans
  • Infant
  • Legg-Calve-Perthes Disease / diagnostic imaging
  • Legg-Calve-Perthes Disease / etiology
  • Male
  • Osteoporosis / diagnostic imaging
  • Osteoporosis / etiology
  • Radiography