PEDIATRICS Vol. 19 No. 6 June 1957, pp. 979-992
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COXA PLANA

Charles T. Ryder M.D.1, John D. LeBouvier M.D.1, and Rosamond Kane M.D.1

1 Department of Orthopaedic Surgery, Columbia University, and the New York Orthopaedic Hospital at the Columbia-Presbyterian Medical Center

IN ITS 46 years as a recognized disease, coxa plana (Legg-Calvé-Perthes disease, pseudocoxalgia, osteochondrosis of the femoral head, etc.) has evoked a tremendous amount of study and speculation, and a bibliography of some 2,000 items. It is discouraging that all this effort has failed to prove a cause or to find a cure for the disease, and it is perhaps more significant that it has not yet even produced a name that everyone can agree to use! The most popular term now seems to be coxa plana ("idiopathic" being implied); this is our preference because it is descriptive, non-committal and avoids the disputed eponym.

Though never a threat to life, coxa plana is a menace to limb; this is its significance. It is exclusively a disease of childhood, but its serious consequences rarely appear before adult life. Because coxa plana is a "new" disease, the nature of these consequences is only now coming to light—indeed Legg's first patients are at present in their fifties.

In the cases currently being studied at the Columbia-Presbyterian and New York Orthopaedic Hospitals, our emphasis has been on the natural history of the disease. This paper is based in part on our findings in 104 patients.

WHAT IS COXA PLANA?

Coxa plana is a disease of the previously normal hip joint in which the bony nucleus of the femoral head becomes necrotic. The dead bone is gradually replaced by the usual stages of bone repair. During this process there is usually some flattening of the normally spherical femoral head. A secondary deformity of the acetabulum develops with growth.

Submitted on October 9, 1956
Accepted on October 30, 1956