Gait abnormalities following slipped capital femoral epiphysis treated with in situ fixation

Henry, Brice; Detrembleur, Christine; Mahaudens, Philippe; Boulet, Sophie; Docquier, Pierre-Louis

doi:10.1016/j.gaitpost.2019.01.036

Cited by 2 publications

(3 citation statements)

References 27 publications

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“…24 More recently, gait analysis of mild and moderate SCFE patients treated with in situ pinning showed an increase in hip extension moment. 25 Comparing the mean FPA of the SCFE side to contralateral side and to control group, no significant difference (Fig. 2) was found.…”

Section: Discussionmentioning

confidence: 84%

“…Another study found an abnormal gait profile for moderate to severe SCFE patients after in situ pinning 24. More recently, gait analysis of mild and moderate SCFE patients treated with in situ pinning showed an increase in hip extension moment 25…”

Section: Discussionmentioning

confidence: 95%

“… 24 More recently, gait analysis of mild and moderate SCFE patients treated with in situ pinning showed an increase in hip extension moment. 25 …”

Section: Discussionmentioning

confidence: 99%

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Minimal Out-Toeing and Good Hip Scores of Severe SCFE Patients Treated With Modified Dunn Procedure and Contralateral Prophylactic Pinning at Minimal 5-year Follow up

Lerch¹,

Boschung²,

Leibold³

et al. 2022

Journal of Pediatric Orthopaedics

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Background: Slipped capital femoral epiphyses (SCFE) is associated with out-toeing of the foot and external rotation gait. But it is unknown if SCFE patients treated with the modified Dunn procedure have out-toeing at follow up. Therefore, we used instrumented gait analysis and questioned (1) do severe SCFE patients treated with a modified Dunn procedure have symmetrical foot progression angle (FPA) compared with contralateral side and compared with asymptomatic volunteers (2) what is the prevalence of out-toeing gait and what are the outcome socres at follow up. Methods: Gait analysis of 22 patients (22 hips) treated with an unilateral modified Dunn procedure for severe SCFE (slip angle >60 degrees, 2002 to 2011) was retrospectively evaluated. Of 38 patients with minimal 5-year follow up, 2 hips (4%) had avascular necrosis of the femoral head and were excluded for gait analysis. Twenty-two patients were available for gait analysis at follow up (mean follow up of 9±2 y). Mean age at follow up was 22±3 years. Mean preoperative slip angle was 64±8 degrees (33% unstable slips) and decreased postoperatively (slip angle of 8±4 degrees). Gait analysis was performed with computer-based instrumented walkway system (GAITRite) to measure FPA with embedded pressure sensors. Patients were compared with control group of 18 healthy asymptomatic volunteers (36 feet, mean age 29±6 y). Results: (1) Mean FPA of SCFE patients (3.6±6.4 degrees) at follow up was not significantly different compared with their contralateral side (5.6±5.5 degrees) and compared with FPA of controls (4.0±4.5 degrees). (2) Of the 22 SCFE patients, most of them (19 hips, 86%) had normal FPA (−5 to 15 degrees), 2 patients had in-toeing (FPA<−5 degrees) and 1 had out-toeing (FPA >15 degrees) and was not significantly different compared with control group. (3) Mean modified Harris hip score (mHHS) was 93±11 points, mean Hip Disability and Osteoarthritis Outcome Score (HOOS) score was 91±10 points. Three patients (14%) had mHHS <80 points and walked with normal FPA. The 2 patients with in-toeing and one patient with out-toeing had mHHS >95 points. Conclusions: Patients with severe SCFE treated with modified Dunn procedure had mostly symmetrical FPA and good hip scores at long term follow up. This is in contrast to previous studies. Although 1 patient had out-toeing and 2 patients had in-toeing at follow up, they had good hip scores. Level of Evidence: Level III—retrospective comparative study.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 95%