[Significance and results of subcapital osteotomy in severe slipped capital femoral epiphysis].
Today treatment with in situ fixation for mild slips in chronic SCFE is undisputed. However, it is far more difficult to give a definite recommendation in cases where a severe dorsal slip of >70 degrees has already occurred. With this position of the femoral head, a severe functional deficit combined with an early onset of osteoarthritis has to be expected. With these severe slips we prefer the subcapital osteotomy, a technique which results in an almost normal anatomical alignment of femoral head and acetabulum. In the literature, this procedure is subject to controversy because of the relatively high incidence of avascular necrosis and chondrolysis. In our own small collective of five patients, we did not observe these complications in the postoperative follow-up and the clinical results were excellent. After 8.5 years the Iowa score was a mean of 91.8 points. Only one patient showed radiological signs of grade I osteoarthritis; the follow-up interval was, however, relatively short.
Arnold
P
P
Orthopädische Universitätsklinik Mannheim, Germany. peter.arnold@ortho.ma.uni-heidelberg.de
Jani
L
L
Soloniewicz
A
A
D000293:Adolescent; D001858:Bone Nails; D002648:Child; D002908:Chronic Disease; D004839:Epiphyses, Slipped / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging / Q000601:surgery*; D005271:Femur Head Necrosis / Q000000981:diagnostic imaging / Q000517:prevention & control; D005500:Follow-Up Studies; D006801:Humans; D007870:Leg Length Inequality / Q000000981:diagnostic imaging; D008297:Male; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000517:prevention & control; D010027:Osteotomy / Q000379:methods*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000517:prevention & control; D011859:Radiography