Long-Term Results of Treatment in Coxa Plana

In eighty-eight patients with 100 hips with coxa plana re-examined ten to forty-five years after treatment, the results were classed as good or excellent in 64 per cent, fair in 17 per cent, and poor in 19 per cent. Treatment for most patients was rest in bed with or without traction. The earlier the age of onset the better the result. When the disease was bilateral, the results were slightly better and usually the final result was the same in each hip. In this series bed rest and traction for a variable period of time was the treatment used for fifty-four patients, more than six months of bed rest without traction was used for seventeen patients, and none or less than six months of bed rest was used for twenty-one patients. Prolonged bed rest did not ensure a good result, and thirteen out of the eighteen treated by none or less than six months of bed rest had good or excellent results. This apparent paradox seemed to be related to the severity of the disease and this could not be correlated with the findings at onset. It was evident after long follow-up that mild to moderate deformity of the femoral head (flattening or coxa magna) is compatible with satisfactory function, with an amount of discomfort and loss of motion that is acceptable to most patients. A progressive deterioration in function with later years did not appear to take place.