Abstract Increasing experience with various histopathologic disturbances of bones and joints has emphasized the frequent occurrence of aseptic necrosis of the head of the femur in fracture and fracture-dislocation at the hip, Legg-Perthes disease, certain congenital dislocations of the hip, and, more recently simple traumatic dislocations of the hip. The pathologic process in all of these conditions seems identical, being due apparently to interference with or interruption of the vascular supply through the ligamentum teres. Aseptic necrosis of the femoral head after simple dislocation is attracting special attention because in the majority of cases when the lesion is recognized irreparable damage has already occurred and the function of the hip has been permanently compromised. Yet it would appear that if the potential injury to the femoral head after a dislocation were appreciated and anticipated the treatment might be so ordered that it would prevent much of the damage to the femoral References 1. Kolodny, A.: The Architecture and the Blood Supply of the Head and Neck of the Femur and Their Importance in the Pathology of Fractures of the Neck , J. Bone & Joint Surg. 7:575-597 ( (July) ) 1925. 2. Chandler, S. B., and Kreuscher, P. H.: A Study of the Blood Supply to the Ligamentum Teres and Its Relation to the Circulation of the Head of the Femur , J. Bone & Joint Surg. 14:835-846 ( (Oct.) ) 1932. 3. Wolcott, W. E.: Circulation of the Head and Neck of the Femur: Its Relation to Non-Union in Fractures of the Femoral Neck , J. A. M. A. 100: 27-34 ( (Jan. 7) ) 1933. 4. Zemansky, A. P., Jr., and Lippman, R. K.: The Importance of the Vessels in the Round Ligament to the Head of the Femur During the Period of Growth, and Their Possible Relationship to Perthes' Disease , Surg., Gynec. & Obst. 48: 461-469 ( (April) ) 1929. 5. Chandler, F. A.: Aseptic Necrosis of the Head of the Femur , Wisconsin M. J. 35:609 ( (Aug.) ) 1936. 6. Phemister, D. B.: Fractures of Neck of Femur, Dislocations of the Hip, and Obscure Vascular Disturbances Producing Aseptic Necrosis of Head of Femur , Surg., Gynec. & Obst. 59:414-440 ( (Sept.) ) 1934. 7. Kleinberg, S., and Buchman, J.: The Operative Versus the Manipulative Treatment of Slipped Femoral Epiphysis, with a Description of a Curative Operation , J. A. M. A. 107:1545-1551 ( (Nov. 7) ) 1936.
Archives of Surgery – American Medical Association
Published: Oct 1, 1939
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