A Study upon Clinical Implication of Growth Disurbance Lines Observable after Reduction of Congenital Dislocation of the Hip

Chang, J S; Song, H Y; Cha, E N; Lee, S H

Abstract

Growth disturbance line as shown radiodense transverse lines at proximal femur regularly appears and stays observable on reduction of congenital dislocation of the hips for about three months to one year period if their age fall between six months and four years(O'Brien 1985, 1986). The lines are usually of inverted "L" shape reflecting displacing physes of femoral head and qreater trochanter. There have been some speculations that changing pattern of growth disturbance line may offer ground for prediction of prognosis. The authors closely examined X-ray changes of 36 hips out of 35children which were apt to observe growth disturbance line for the span of 2years and 7months time in average(1-4 3/12 years) after reduction. There of are to be reported as follows. 1. 36 hips, growth disturbance line was observable in all but 3 hips at 1 year or longer period of follow-up. 2. Normal pattern of growth disturbance line was observed in 28hips. Male in 6 and female in 22cases, and their average age was 1.6 years. Theatment offered were closed reduction in 15hips, open reduction in 3hips, innominate osteotomy in 9 hips and femoral shortening in 1 hip. Follow-up results of these cases were excellent in 13(45.5%), good in 15(54.5%) according to Severin's criteria. 3. Abnormal pattern of growth disturbance line was observed in 5hips. They were all female, and their age at reduction was 8.8 months. Treatment, offered were closed reduction in 3 hips and open reduction in 2 hips.(The results were fair in 4 cases and poor in 1 case). From above observations, the pattern of growth disturbance line which appears after reduction of congenitally dislocated hips seems to be helpful for prediction of prognosis in fairy early stage.