A new classification is proposed for post-reduction necrosis of the femoral epiphysis based on retrospective analysis of 54 cases with a mean follow-up of 15 years. Necrosis can be divided under two main headings:
A) partial, involving only the epiphysis
B) total, involving the metaphyseal cartilage.
Four total forms have been identified:
B1: eventually resulting in coxa valga
B2: eventually resulting in a short stubby neck, oval head and coxa magna
B3: eventually resulting in coxa vara and severe acetabular dysplasia
B4: eventually resulting in hypoplasia of the whole hip joint.
This classification system comprises all the aspects of necrosis, while at the same time providing guidelines for treatment and long-term planning.
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