[Analysis of the metaplastic disturbances in dislocated hip joints in the orthopedic hospital of the Medical Academy in Magdeburg (author's transl)].

One of the most frequent and prognostically unfavorable complications occurring with therapy for dislocated hip joints is a metaplastic disturbance at the coxal end of the femur. We undertook a differentiation between metaplastic disturbances in necrosis of the center of the femur head and restorative disturbances. In the evaluated period between 1964 and 1974, 1298 children (2236 treated hips) were examined. Between 1965 and 1968 when the old, classical therapy for dislocation was employed, we established a metaplastic disturbances rate of 20%. The rate for necrosis of the femur head was 9% and the restorative disturbance rate was 11%. The metaplastic disturbance rate was lowered to 5.65% as a result of the modern, functional, early therapy instituted between 1969 to 1974. Here we established a rate of necrosis for the femur head of 0.45% and a restorative disturbance rate of 5.2%. This falls within the range established by Huber (5.5%) and Unger (6.06%). The possibility of an endochondral dysostosis must always be considered when bilateral restorative disturbances are present. We observed that restorative disturbances always occurred more frequently in connection with dysplasias. We fell that the cause is the endogenous tendency toward restorative disturbances of the center of the femur head. With early therapy, the possibility of a dislocation can, however, be avoided. In contrast to Kiltz, our later results and follow-up examinations indicate a poorer prognosis for necroses of the center of the femur head.