Roentgenographic analysis of the avascular necrosis of the femoral head following treatment of congenital dislocation of the hip.

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We carried out a roentgenographic analysis of 83 patients with congenital dislocation of the hip complicated by avascular necrosis. This was done to clear up the relationship between damage of the femoral head and that of the femoral neck. All patients had been reduced by Lorenz's method and never received surgical treatment over ten years. They were classified into three groups of good, fair and poor according to Mose's method. Epiphyseal quotient (E. Q.) and articulo-trochanteric distance (A. T. D.) were measured to evaluate the degree of damage at the femoral head and neck on each group. We found that E. Q. did not correlate with A. T. D. in the group of good and fair, but in the poor group they correlated statistically. Most of good and fair groups belonged to the Kalamchi's group 1 (mild epiphyseal involvement), and most of poor group belonged to the Kalamchi's group 2 (involvement of the growth plate and epiphysis) or group 4 (involvement of all of epiphysis, growth plate and metaphysis)Those facts mean that growth disturbance at the epiphysis and at the metaphysis occurs independently in the most of mildly deformed femoral head, but on the contrary they occur relationally in the severely deformed femoral head. It suggests that there is a difference in site of vascular occlusion on the avascular necrosis of the femoral head following treatment of congenital dislocation of the hip.
西日本整形・災害外科学会の論文