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

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.

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Introduction

Hipdysplasiacanhavevariouscauses.Congenitalhipdysplasiadevelopsduringintrauteri-

nelifeasar