What causes congenital flat hips

Osteochondris of the femoral head is mainly caused by various factors caused by the clinical symptoms caused by the ischemic epiphysis of the femoral head epiphysis, such as necrosis, also known as flat hip, megahip, Legg-Calveperthes disease, Perthes disease, femoral head epiphysis, femoral head osteochondritis, avascular necrosis of the femoral head, aseptic necrosis of the femoral head, etc. The ** of this disease is unknown, mainly related to the following factors: (1) chronic injury; (2) increased intra-articular pressure caused by injury or inflammation; (3) congenital anomalies and defects; (4) Genetic and endocrine sail deficiency disorders.

The clinical manifestations are mainly early claudication, hip, thigh or knee soreness, limited hip joint movement, progressive aggravation of symptoms, thigh muscle atrophy, and late complications of osteoarthritis. The disease is more common in children aged 3-12 years, of which 4-8 years old is more common, more males than females (about 4:1), mostly unilateral, a few bilateral (about 15%), slow onset, long course of disease.

The disease can be cured spontaneously, but the prognosis is long (2-4 years), the prognosis is difficult to estimate, and the pathological changes cannot be reversed. If it is early, the effect is better, and it has little effect on the function of the hip joint. If it is delayed** or not regular**, the efficacy is not good, and it has a greater impact on hip function, and complications of osteoarthritis can also occur.

Therefore, early diagnosis and early diagnosis are extremely important, and secondly, they have a profound impact on the effect and prognosis.

1.Early painful claudication, soreness and stiffness in the hips, thighs or knees. The pain worsens after activity and is relieved with rest.

2.There is tenderness in the hip and medial groin, and spasms of the adductor muscle groups. Hip abduction and rotation are limited, followed by hip flexion and anisotropic mobility, and hip flexion and adduction deformity. Atrophy of the muscles of the thighs and buttocks.

3.In the later stage, a small number of patients have varying degrees of improvement in symptoms and signs, and some can turn into osteoarthritis.

1.**The purpose is to avoid compression of the necrotic femoral head, improve blood circulation to the femoral head, prevent the occurrence of deformity or reduce the degree of deformity, and restore the function of the hip joint as soon as possible. There are three ways to do this:

1) Avoid weight-bearing. (2) Increase the coverage of the acetabulum on the femoral head and change its bearing weight. (3) Increase the blood circulation of necrotic femoral head.

2.Long-term bed rest is not weight-bearing, and ischial weight-bearing brackets should be used when going down to the ground.

3.Patients with hip pain and flexion deformity should be placed in bed for traction, and when the pain disappears and activities are resumed, a protective brace is used. Use an abducted and slightly internally rotated brace or cast to incorporate the epiphysis of the entire ** bone into the acetabulum.

4.Ongoing functional exercises for the affected limb.

5.Supplemented with traditional Chinese medicine such as blood circulation and blood stasis: such as Tai'an Capsule, Injury Bone Tablets or Panax Panax Panax Tablets, etc.

6.Surgery**:(1) When the femoral head is completely involved and the deformity is severe and the acetabulum cannot cover the femoral head, subtrochanteric rotational inversion osteotomy, pelvic osteotomy or femoral head vascular bundle implantation can be used according to the situation to cover the femoral head and improve the blood circulation of the femoral head.

2) The epiphysis of the femoral head has been obviously necrotic or has been fragmented, but the deformation is not serious. Hip synovial or large part of the joint capsule can be resected, or partial synovectomy with vascular implantation can be performed. However, it is not indicated for patients with advanced stages of severe deformity of the femoral head neck.

1.Non-surgical** patients generally do not require medication** or can use Chinese medicine**.

2.If surgery** is required, intravenous antibiotics and support are required after surgery, and symptomatic treatment is required**. Those with a lot of bleeding or poor physical fitness need blood transfusion or human albumin.

Basis for diagnosis.

1.It usually occurs in children between the ages of 4 and 8 years.

2.In the early stage, there is claudication, hip pain, tenderness, and limited movement, especially abduction, flexion, and internal rotation.

3.Advanced osteoarthritis changes.

Radiographs show early spherical swelling of the hip capsule, smaller epiphysis of the femoral head, widening of the epiphyseal line, widening of the joint space, and irregular osteoporosis or cystic changes in the area connecting to the neck. This is followed by an uneven increase in epiphyseal density and a "crescent sign" of subchondral fractures (a well-defined strip of dedensity, under the cartilage on the anterolateral aspect of the femoral head). The epiphysis appears fragmented or granular, the femoral head becomes flattened, and the femoral neck becomes wider and shorter, progressively worsening.

Finally, the loose area was recalcified and the fragments fused, reproducing the normal trabecular bone structure, but the femoral head was mostly flattened, wide, and subluxated, and the femoral neck was wide and short. Osteoarthritic changes occur in advanced stages.