[Chondrolysis with protrusion and stiffness of the hip in puberty]

With reference to 5 recently observed cases, and after a review of the literature, the rare and hitherto inadequately clarified complex of stiffness of the hip in puberty is considered. The primary condition--chondrolysis, not necrosis of the head--is typified by destruction with subsequent layered fibrosis of the tissue at the cartilage/bone transition point, mainly at the head of the femur and the acetabulum. The clinical picture is an independent one, accompanied by synovitis and in severe cases leading to fibrous ankylosis. It is not only seen in females with deep and protruding acetabuli, beginning usually between the ages of 10 and 16; it also occurs as a complication of femoral head epiphysiolysis in boys and occasionally also after trauma and inflammations in the hip region. In severe cases the treatment of these events, which even occur occasionally on the "healthy" side, is unsatisfactory. Early relaxation surgery still seems to be the most effective treatment, by reducing the pressure on the base of the acetabulum which probably occurs in these cases. All treatment should be performed in carefully timed and measured stages, "sneaking up" on the irritation.