Femoral Morphologic Differences in Subtypes of High Developmental Dislocation of the Hip
- 1 December 2010
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Clinical Orthopaedics and Related Research
- Vol. 468 (12), 3371-3376
- https://doi.org/10.1007/s11999-010-1386-5
Abstract
Previous studies show the shape of the femur in developmental dislocation of the hip (DDH) becomes more abnormal with increasing subluxation. Two kinds of high dislocations associated with DDH have been observed in clinical practice, one with (Type C1) and one without (Type C2) a false acetabulum. The presence or absence of a false acetabulum in high dislocated hips is associated with different loading patterns and could influence the development and shape of the proximal femur. We therefore determined whether (1) the proximal femoral shape and dimension in Type C1 and Type C2 hips differ from each other, and (2) the femur dislocated with the same height in Types C1 and C2 hips. We examined the following variables on 54 proximal femurs from 54 patients with high DDH (28 Type C1 hips and 26 Type C2 hips) on AP and lateral radiographs; the ML widths of the cortical and medullary canals, height of the femoral head, height of dislocation, and height of the greater trochanter. Reproducibility of the measurements was tested by two researchers with high interobserver and intraobserver agreement. The proximal femur in Type C2 hips was narrower and stovepipe shaped, with a smaller flare index (2.7 ± 0.6), compared with Type C1 hips (3.5 ± 1.2). The proximal femur migrated an average of 18 mm more superiorly in Type C2 than in Type C1 hips. Our data confirm distinctions in the shape of the proximal femur in the presence and absence of a false acetabulum. Owing to the abnormal shapes, special implants of different geometries or modular stems may be needed for reconstruction Type C2 high dislocations.Keywords
This publication has 17 references indexed in Scilit:
- Cementless total hip replacement with subtrochanteric femoral shortening for severe developmental dysplasia of the hipThe Journal of Bone and Joint Surgery. British volume, 2009
- The Morphologic Variations of Low and High Hip DislocationClinical Orthopaedics and Related Research, 2008
- Results on Total Hip Arthroplasties With Femoral Shortening for Crowe's Group IV Dislocated HipsThe Journal of Arthroplasty, 2007
- Cementless Total Hip Arthroplasty in Patients with High Congenital Hip DislocationPublished by Ovid Technologies (Wolters Kluwer Health) ,2006
- Total Hip Arthroplasty in Developmental High Dislocation of the HipThe Journal of Arthroplasty, 2005
- Total Hip Arthroplasty in Adult Patients Who Had Developmental Dysplasia of the HipThe Journal of Arthroplasty, 2005
- Three-dimensional anatomy of the hip in osteoarthritis after developmental dysplasiaThe Journal of Bone and Joint Surgery. British volume, 2005
- Cementless Total Hip Arthroplasty and Limb-Length Equalization in Patients with Unilateral Crowe Type-IV Hip DislocationThe Journal of Bone & Joint Surgery, 2005
- Femoral shortening and cementless arthroplasty in high congenital dislocation of the hipThe Journal of Arthroplasty, 2002
- Femoral Deformity in Adults With Developmental Hip DysplasiaClinical Orthopaedics and Related Research, 1996