[Treatment of chronic slipped capital femoral epiphysis : Use of dynamic epiphyseal telescopic screws].
BACKGROUND
Slipped capital femoral epiphysis (SCFE) is a multifactorial structural loosening in the area through the epiphyseal plate between the epiphysis and metaphysis accompanied by slippage of the femoral head in the mid-dorsal-caudal direction without additional adequate trauma. In this retrospective study, all patients with chronic SCFE were assessed who had been treated by implanting a dynamic epiphyseal telescopic (DET) screw.


METHODS
All patients who had been treated at our hospital with a DET screw implant between December 2006 and November 2014 following diagnosis of chronic SCFE were included in the study. Clinical and radiological follow-up was carried out after 6 weeks, 12 weeks, and then every 6 months.


RESULTS
In all patients, the SCFE proved to have been firmly fixed and no further slippage was observed in any patient on the side affected. None of the prophylactically treated hips showed secondary SCFE either. In all patients, the DET screw led to partial remodeling of the slippage. The average slippage angle according to Southwick (epsilon angle) was about 30° preoperatively and about 19° in the most recent radiological follow-up. The alpha angle according to Nötzli was about 91° preoperatively and about 62° in the most recent radiological follow-up. Most of the patients showed none treatment-related dysfunction.


CONCLUSIONS
Surgical treatment with a DET screw seems to be a safe procedure for both the affected hip and the hip to be treated prophylactically. This method is an adequate alternative to the widespread technique of pinning with K‑wires.
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland. Eckehard.schumann@uniklinik-leipzig.de.
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Schumann
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
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Zajonz
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
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Wojan
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
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Kübler
Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
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Brandmaier
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
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Josten
Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland.
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Heyde
Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
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Bühligen
D000293:Adolescent; D001863:Bone Screws; D002648:Child; D004838:Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D019544:Equipment Failure Analysis; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008137:Longitudinal Studies; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D060048:Slipped Capital Femoral Epiphyses / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome
Epiphyseal plate; Kirschner wires; Osteotomy; Slipped capital femoral epiphysis; Telescopic screws