title: [Eccentric ossification of the femur head epiphysis in hip dislocation; consequences for diagnosis and therapy].
abstract: Ossification of the upper femoral epiphysis is dependent on biomechanical laws. In babies with normal hips, the osseous nucleus develops in the centre of the epiphysis. In babies with hip dislocation, however, the altered biomechanical factors result in a different location of the nucleus. Ossification begins in a more lateral and cranial position. After reduction of the dislocated hip, either a second nucleus forms and grows together with the first nucleus, or the eccentric nucleus extends in a caudal direction. Both of these alternatives are physiological processes and should not be confused with necrosis of the epiphysis. The eccentric development of the nucleus is hardly mentioned in the modern literature, but it is of the greatest importance for diagnosis and therapy. Ignorance of the phenomenon of eccentric ossification may lead to a false assessment of the position of the femoral head. This mistaken impression may be heightened by an inappropriate X-ray technique: only by using techniques which take into account that the middle rotation position in children is different from that in adults can mistaken diagnoses and unnecessary operations be avoided. Examples are presented.
mesh_terms: D002358:Cartilage, Articular / Q000473:pathology; D003937:Diagnosis, Differential; D004838:Epiphyses / Q000473:pathology*; D005260:Female; D005270:Femur Head / Q000473:pathology*; D006618:Hip Dislocation, Congenital / Q000473:pathology* / Q000628:therapy; D006801:Humans; D007223:Infant; D008297:Male; D009999:Ossification, Heterotopic / Q000473:pathology*
vernacular_title: Die exzentrische Ossifikation der Hüftkopfepiphyse bei der Hüftluxation; Konsequenzen für Diagnose und Therapie.