Vascular disorders of the proximal femur following treatment of congenital hip dislocation.

Abstract

Early diagnosis of congenital dislocation of the hip entails treating patients in a very young age-group. These patients present a high risk of vascular disorder in the femoral capital epiphysis in the course of either surgical or nonsurgical treatment. Thirty-five cases of anomalies in the proximal femur of vascular origin were observed, corresponding to 3% of hips treated for congenital dislocation. Roentgenographic diagnostic elements are included in an evolutive classification. In recent cases, radionuclide bone scans were used to obtain supplementary information. Based on bone scans, two distinct groups of patients can be identified: in the first group, vascular disorders of the proximal femur (VDPF) are iatrogenic in origin; in the second, VDPF are due either to the precariousness of prereductional blood flow to the epiphysis or to the summation of risk factors.