development of hip dysplasia in pty due to delayed ossification the femoral nucleus由于股骨核骨化延迟中髋关节发育不良发展.pdfVIP
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Summary
Besidescongenitalhipdysplasia,therearedysplasiasthatdonotdevelopuntilpuberty,
causingsubluxationofthefemoralheadtooccurlateintheskeletalgrowthperiod.These
dysplasiashavevariouscauses.Osteochondritisandosteochondronecrosishavebeendes-
cribed.
Inthetwosiblingsdescribedinthisstudy,theboyshowedaconspicuousdelayinthe
appearanceofthefemoralossificnucleiandinthefusionofthetriradiatecartilages,whichoc-
curredat16yearsofageintheboyandat13—14yearsinthegirl.Thiswasprecededby
conspicuousstructuralchanges,especiallyintheposteriortriradiatecartilageandacetabular
roofbutalsoaffectingthelateralgrowthcenterofthefemoralneck,whichwashorizontalover
two-thirdsofitsdiameter.
Weknowfromanimalstudiesthatthegrowthofthetriradiatecartilageincreasesthe
diameteroftheacetabulumbutnotitsdepth.Theacetabulumisdeepenedbypressurefrom
thefemoralhead.Asaresultofcoxavalgaandaprolongedperiodofacetabularexpansion,
combinedwithabnormalitiesofthesuperioracetabularrim,thefemoralheadsinthesechild-
reneventuallysubluxatedpasttheacetabularrim.Thescleroticlinealongtheweight-bearing
zoneoftheacetabularroofwasshortenedandthickenedinbothchildren,settingthestagefor
osteoarthriticchangesinlaterlife.
Wheneverdevelopmentofthefemoralossificnucleusisdelayedduringthefirstyearoflife,
radiographicfollow-upsshouldbeinstitutedat8yearsofage.Atransiliacacetabularosteoto-
mycanenlargetheacetabularroofandimprovetheacetabularindexupto10—12yearsof
age.Lateratriplepelvicosteotomycanprovidefurtherimprovement.
2
Introduction
Hipdysplasiacanhavevariouscauses.Congenitalhipdysplasiadevelopsduringintrauteri-
nelifeasar
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