[Reduction of epiphyseal displacement and fixation in the treatment of unstable slipped capital femoral epiphysis].
Reduction of epiphyseal displacement by manipulation in the treatment of unstable slipped capital femoral epiphysis (scfe) can lead to very severe complications as avascular necrosis or acute necrosis of cartilage. The aim of this study is to analyze the results of treatment of unstable scfe with open reduction and fixation. Material consists of 14 patients (10 boys and 4 girls) with 15 hips treated surgically because of unstable scfe with an average follow up of 10 years and 6 months (ranged from 2 to 26 yrs). The age of the patients ranged from 9 to 17 yrs (mean 13). There was 14 cases of acute-on-chronic slips and 1 acute slip. The slip angle measured on anteroposterior radiographs ranged from 27 degrees to 57 degrees (mean 39 degrees) and on frog lateral radiographs ranged from 52 degrees to 81 degrees (mean 67 degrees). In all of the cases manipulated reduction and internal fixation was done. The mean amount of correction was 30 degrees measured on anteroposterior radiographs (from 7 degrees to 55 degrees) and 37 degrees on frog lateral radiographs (from 8 degrees to 82 degrees). An end results were classified according to Hall and Southwick classification with Szypryt modification.


RESULTS
Excellent result was achieved in 6 hips (40%), good in 4 hips (27%), fair in 3 (20%) and poor in 2 (13%). Avascular necrosis developed in 2 hips. There was no cases with acute necrosis of cartilage.


CONCLUSIONS
Reduction of epiphyseal displacement and fixation is a save procedure in the treatment of unstable slipped capital femoral epiphysis. Severe under-correction as well as over-reduction can lead to unsatisfactory results.
Koczewski
Paweł
P
Katedra i Klinikia Ortopedii i Traumatologii Dzieciecej, Akademia Medyczna im. Karola Marcinkowskiego w Poznaniu.
D000293:Adolescent; D002648:Child; D004839:Epiphyses, Slipped / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005270:Femur Head / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D011859:Radiography; D013997:Time Factors; D016896:Treatment Outcome