ACUTE SLIPPED CAPITAL FEMORAL EPIPHYSIS - RESULTS OF SURGICAL THERAPY AND REVIEW OF THE PROBLEMS

Czech version

Authors: Pavel Šponer
Authors‘ workplace: Department of Orthopaedic Surgery, University Hospital, Hradec Králové ; Ortopedická klinika LF UK a FN, Hradec Králové
Published in: Úraz chir. 14., 2006, č.1

Overview

The aim of the study is to provide the evaluation of the operative treatment results in acute juvenile slipped capital femoral epiphylis. Between 1996 and 2003 twenty-three hip joints were operated on in nineteen children, four children underwent bilateral surgery. The age at the time of surgery was 10–15 years. There was chronical slip in 17 hips. Six patients with acute slipped capital femoral epiphysis were included in the study. The follow-up was 2–8 years with an average period of 4,5 years after the surgery. The postoperative evaluation partly focussed on subjective complaints, on range of motion, walking ability and length of lower extremities with the use of the system published by Heyman and Herndon, and partly focussed on hip radiographs. Mild slipped capital femoral epiphysis was mannaged in 3 hip joints and severe in 3 joints. Stable slipped capital femoral epiphysis was in 3 cases, unstable in 3 hips. The Heyman and Herndon clinical rating was excellent in 3 hip joints. Poor clinical rating for mild limping without pain was in 2 hips and 1 patient had a mild limping and pain after exercise.

Key words:
slipped capital femoral epiphysis, in situ stabilization, femoral osteotomy.

Sources

1. BETZ, R.R., STEEL, H.H., EMPER, W.D., HUSS, G.K., CLANCY, M. Treatment of slipped capital femoral epiphysis. Spica cast immobilization. J Bone Joint Surg. 1990, 72-A, 587–600.

2. BOYER, D.W., MICKELSON, M.R., PONSETI, I.V. Slipped capital femoral epiphysis. Long-term follow-up study of one hundred and twenty-one patients. J Bone Joint Surg. 1981, 63-A, 85– 95.

3. BRODETTI, A. The blood supply of the femoral neck and head in relation to the damaging effects of nails and screws. J Bone Joint Surg. 1960, 42-B, 794–801.

4. BROUGHTON, N.S., TODD, R.C., DUNN, R.M., ANGEL, J.C. Open reduction of the severely slipped upper femoral epiphysis. J Bone Joint Surg. 1988, 70B, 435–439.

5. CANALE, S.T. Fractures and dislocations in children. In: CANALE, S.T. (ed.): Campbell´s operative orthopaedics. 9th ed. St. Louis: Mosby 1998. 2363–2536.

6. CARNEY, B.T., WEINSTEIN, S.L., NOBLE, J. Long-term follow-up of slipped capital femoral epiphysis. J Bone Joint Surg. 1991, 73-A, 667–674.

7. CASEY, B.H., HAMILTON, H.W., BOBECHKO, W.P. Reduction of acutely slipped upper femoral epiphysis. J Bone Joint Surg. 1972, 54-B, 607–614.

8. ČECH, O. Stabilní osteosyntéza v traumatologii a ortopedii. 2. vyd. Praha: Avicenum, 1982. 307 s.

9. DIETZ, F.R. Traction reduction of acute and acute-on-chronic slipped capital femoral epiphysis. Clin Orthop. 1994, 302, 101–110.

10. DUNN, D.M., ANGEL, J.C. Replacement of the femoral head by open operation in severe adolescent slipping of the upper femoral epiphysis. J Bone Joint Surg. 1978, 60-B, 394–403.

11. FAHEY, J.J., O´BRIEN, E.T. Acute slipped capital femoral epiphysis: review of the literature and report of ten cases. J Bone Joint Surg. 1965, 47-A,1105–1127.

12. FAIRBANK, J.T. Manipulative reduction in slipped capital femoral epiphysis. J Bone Joint Surg. 1969, 51-B, 252–262.

13. GRIFFITH, M.J. Slipping of the capital femoral epip-hysis. Ann R Coll Surg Engl. 1976, 58, 34–42.

14. HERRING, J.A. Slipped capital femoral epiphysis. In: HERRING, J.A. (ed.): Tachdjian´s Pediatric Orthopaedics. 3rd ed. Philadelphia: W.B. Saunders Company, 2002. 711–764.

15. HEYMAN, C.H., HERNDON, C.H. Epiphysiodesis for early slipping of the upper femoral epiphysis. J Bone Joint Surg. 1954, 36-A, 539–554.

16. IMHAUSER, G. Spätergebnisse der sog. Imhauser-osteotomie bei der Epiphysenlosung. Zugleich ein Beitrag zum Problem der Hűftarthrose. Z Orthop. 1977, 115, 716–725.

17. KALLIO, P.E., MAH, E.T., FOSTER, B.K., PATER-SON, D.C., LeQUESNE, G.W. Slipped capital femoral epiphysis. Incidence and assessment of physeal in-stability. J Bone Joint Surg. 1995, 77-B, 752–755.

18. KARPÍŠEK, M., DUNGL, P., KILIJÁN, J. Juvenilní proximální femorální epifyzeolýza – souhrn problematiky a výsledky operační léčby. Acta Chir Orthop Traumatol Cech. 1993, 60, 344–350.

19. KITADAI, H.K., MILANI, C., NERY, C.A., FILHO, J.L. Wiberg´s center-edge angle in patients with slipped capital femoral epiphysis. J Pediatr Orthop. 1999, 19, 97–105.

20. KRAUSPE, R., WILD, A., WESTHOFF, B. Slipped capital femoral epiphysis (SCFE). In: THORNGREN, K.G., SOUCACOS, P.N., HORAN, F., SCOTT, J. (eds.): European Instructional Course Lectures. London: The British Editorial Society of Bone and Joint Surgery, 2001. 83–90.

21. LODER, R.T. The demographics of slipped capital femoral epiphysis. An international multicenter study. Clin Orthop. 1996, 322, 8–27.

22. LODER, R.T., RICHARDS, B.S., SHAPIRO, P.S., REZNICK, L.R., ARONSON, D.D. Acute slipped capital femoral epiphysis: the importance of physeal stability. J Bone Joint Surg. 1993, 75, 1134–1140.

23. MEIER, M.C., MEYER, L.C., FERGUSON, R.L. Treatment of slipped capital femoral epiphysis with a spica cast. J Bone Joint Surg. 1992, 74-A, 1522–1529.

24. MULHOLLAND, R.C., GUNN, D.R. Sliding screw plate fixation of intertrochanteric femoral fractures. J Trauma. 1972, 12, 581–591.

25. PETERSON, M.D., WEINER, D.S., GREEN, N.E., TERRY, C.L. Acute slipped capital femoral epiphysis: the value and safety of urgent manipulative reduction. J Pediatr Orthop. 1997, 17, 648–654.

26. RAO, J.P., FRANCIS, A.M., SIWEK, C.W. The treatment of chronic slipped capital femoral epiphysis by biplane osteotomy. J Bone Joint Surg. 1984, 66-A, 1169–1175.

27. SOUTHWICK, W.O. Osteotomy through the lesser trochanter for slipped capital femoral epiphysis. J Bone Joint Surg. 1967, 49-A, 807–835.

28. ŠPONER, P. Stabilizace skluzu proximální femorální epifýzy v adolescentním věku. Lék. Zpr. LF UK Hradec Králové. 2005, 50, 89–97.

29. TACHDJIAN, M.O. Slipped capital femoral epiphysis. In: TACHDJIAN, M.O. (ed.): Pediatric Orthopedics. 2nd ed. Philadelphia: W.B. Saunders Company 1990. 1016–1081.

30. VRETTOS, B.C., HOFFMAN, E.B Chondrolysis in slipped upper femoral epiphysis. Long-term study of the aetiology and natural history. J Bone Joint Surg. 1993, 75-B, 956–961.

Labels

Surgery Traumatology Trauma surgery

TREATMENT OF CALCANEAL FRACTURES – PART I.

FRACTURE OF THE CALCANEUS - LIFE THREATENING INJURY

INTERNAL FIXATION OF FEMORAL NECK FRACTURES IN ELDERLY PATIENTS: COMPARISON OF TECHNIQUES

Article was published in

Trauma Surgery

2006 Issue 1