Gamble J G, Mochizuki C, Bleck E E, Rinsky L A
J Pediatr Orthop. 1985 Sep-Oct;5(5):528-33. doi: 10.1097/01241398-198509000-00004.
We studied coxa magna after operative treatment of congenital dislocation of the hip, including incidence, relationship to treatment, and influence of coxa magna on the acetabulum. Coxa magna was defined as a femoral head with a horizontal diameter at least 15% greater than the symmetrical position on the opposite side. Coxa magna developed in 16 hips (33%). The mean increase was 20.9% (range 15-30%). Three factors correlated with coxa magna: femoral osteotomy (100%), open reduction (75%), and operation at a younger age (mean 15.6 vs. 35.8 months). Four of the 16 hips developed coxa magna following Type 1 avascular necrosis; no other growth deformities appeared. At follow-up, the acetabular indices and the center edge angles were not statistically different between the coxa magna and the control groups. One must avoid confusing coxa magna with hip subluxation or inadequate reduction, of which the latter requires appropriate treatment. Coxa magna gives a good hip if a concentric, congruous reduction is obtained, providing the acetabulum has enough growth potential for remodeling.
我们研究了先天性髋关节脱位手术治疗后的大髋，包括其发生率、与治疗的关系以及大髋对髋臼的影响。大髋被定义为股骨头的水平直径至少比另一侧对称位置大15%。16个髋关节（33%）出现了大髋。平均增加20.9%（范围15%-30%）。与大髋相关的三个因素为：股骨截骨术（100%）、切开复位（75%）以及手术时年龄较小（平均15.6个月对35.8个月）。16个髋关节中有4个在1型无菌性坏死之后出现大髋；未出现其他生长畸形。随访时，大髋组与对照组之间的髋臼指数和中心边缘角无统计学差异。必须避免将大髋与髋关节半脱位或复位不充分相混淆，后者需要适当治疗。如果获得同心、匹配的复位，且髋臼有足够的生长潜力进行重塑，大髋可形成良好的髋关节。
