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Osteochondritis dissecans of the femoral head in children and adolescents: a report of 17 cases.

Osteochondritis dissecans of the femoral capital epiphysis is uncommon and is usually reported as a case report or in association with other diseases. This study reports 17 cases with the primary underlying diagnosis of Legg-Calvé-Perthes disease in seven, idiopathic in six, avascular necrosis following trauma in three, and avascular necrosis with previous infection in one. Twelve cases had long-term follow-up. Two cases in which no surgery was performed were followed for an average of 12.5 years; 10 cases in which surgery was performed were followed for an average of 16.1 years. Excision of the osteochondritis fragment was performed in six cases. It was necessary only to dislocate the hip to excise the lesion in five cases. No morbidity resulted from temporary surgical dislocation. Excision of the osteochondritis dissecans fragment allowed these six patients to return to fairly normal living during the time of follow-up.