Late Perthes disease after satisfactory treatment of congenital dislocation of the hip.

Abstract

Late Perthes disease in children treated conservatively for congenital dislocation of the hip with good results seems rare. To our knowledge 14 cases have been reported in the literature. Three new cases, found among 2500 children with congenital dislocations of the hip, treated during the last 35 years are presented. The ages of the patients at admission were 14, 3, and 18 months, and late Perthes disease was seen 24, 26, and 36 months, respectively, after successful conservative treatment of congenital dislocation of the hip. This condition has differences from other types of ischemic necrosis of the proximal end of the femur. The changes are severe and involvement of the acetabulum contributes significantly to acetabular deficiency and subluxation. Severe deformities of the proximal end of the femur and the acetabulum are responsible for failure of reconstructive procedures such as shelf and Chiari's operations in two of our patients. The cause of this condition is unknown.