Visually controlled intertrochanteric osteotomy in chronic adolescent slipped capital femoral epiphysis.
OBJECTIVE
In clinical practice, proper three-dimensional planning and implementation of intertrochanteric correction of femoral epiphyseal alignment are usually sidestepped because of their complexity and replaced by more or less effective approximations.


METHODS
After transverse osteotomy and in the absence of geometric planning procedures, the proximal part is manipulated and mobilized into its correct position under image intensification. After the second, parallel osteotomy, an appropriately dimensioned and aligned correction wedge emerges "automatically".


METHODS
In contrast to conventional intertrochanteric correction osteotomy, the seating chisel for angled-blade plating is only positioned after osteotomy and wedge excision have been completed. A short element of the external fixator system is temporarily mounted at the greater trochanter for the purpose of manipulation and stabilization of the proximal part. Osteosynthesis corresponds to the osteotomy cut at right angles to the femoral shaft and is performed using the adult or adolescent 90 degrees angled-blade plate.


RESULTS
This modified technique for intertrochanteric correction osteotomy has proven its worth in clinical practice for 19 years despite the rather more complex surgical procedure. In nine patients, anatomically permissible realignment of the epiphysis was achieved in the intertrochanteric region without specific complications.
Gekeler
Jörg
J
Orthopädische Abteilung, Städtisches Krankenhaus, Sindelfingen. joerg.gekeler@web.de
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002908:Chronic Disease; D004839:Epiphyses, Slipped / Q000601:surgery*; D016267:External Fixators; D005270:Femur Head; D006801:Humans; D010027:Osteotomy / Q000379:methods*; D016896:Treatment Outcome