Early and middle term results after surgical treatment for slipped capital femoral epiphysis.
OBJECTIVE
To evaluate the early and middle-term results of in situ single screw fixation and subtrochanteric osteotomy of the femur with external fixator for slipped capital femoral epiphysis (SCFE).


METHODS
From June 1998 to July 2008, 11 patients (seven male [eight hips] and four female [four hips]) of average age 14.3 years (range, 9-18 years) were treated in our hospital. According to the Southwick measurement, seven hips were mildly affected (<30°), two moderately (30-50°), and three severely (>50°). The average body mass index (BMI) was 31.1 g/m(2) (range, 27-35 g/m(2) ). All the mild and moderate cases underwent in situ single screw fixation, and the three severe cases subtrochanteric osteotomy of femur with external fixator. All cases were evaluated both clinically and radiographically at 3 months, 6 months and every year postoperatively.


RESULTS
All cases were followed up for 2-12 years (average 5.6 years). The Harris hip score increased from a mean of 74.8 (70 ∼ 85) points preoperatively to 90.6 (70 ∼ 100) points postoperatively. X-ray films showed epiphyseal closure in the in situ single screw fixation cases, and no further increase in epiphyseal-shaft angle. Partial reduction of slipped epiphysis with normal joint spaces was observed after subtrochanteric osteotomy of the femur in the external fixator cases.


CONCLUSIONS
In situ single screw fixation for treating mild and moderate SCFE has a satisfactory clinical outcome, and the advantage of prevention of further slippage. Subtrochanteric osteotomy of the femur with external fixator is suitable for severe SCFE with late deformity; the realignment procedure can correct deformity and postpone or prevent subsequent osteoarthritis.
The Center of Osteonecrosis and Joint Preservation and Reconstruction and Department of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, China.
Wei
W
Sun
Zi-rong
ZR
Li
Zhen-cai
ZC
Shi
Yu-run
YR
Yang
Bai-liang
BL
Wang
Wan-shou
WS
Guo
Zhao-hui
ZH
Liu
D000293:Adolescent; D001863:Bone Screws; D002648:Child; D042241:Early Diagnosis; D016267:External Fixators; D005260:Female; D005269:Femur / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010027:Osteotomy / Q000379:methods; D011182:Postoperative Care / Q000379:methods; D011859:Radiography; D060048:Slipped Capital Femoral Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome