Pinning in slipped capital femoral epiphysis: long-term follow-up study

Boero, Silvio; Carbone, M.; Stella, G.; Calevo, Maria Grazia

doi:10.1097/01202412-200311000-00004

Cited by 10 publications

(13 citation statements)

References 30 publications

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“…Severity is also considered as a risk factor but only for unstable slippages. 3,9,28,30 Surgical modalities are also very controversial there are no good data supporting one approach over another. There are three objectives in SCFE surgery: avoiding further slippage, avoiding complications, having the best functional outcome.…”

Section: Discussionmentioning

confidence: 99%

“…There are three objectives in SCFE surgery: avoiding further slippage, avoiding complications, having the best functional outcome. 30 Closed manipulative reduction and open reduction are blamed as important risk factors for femoral head devascularization 3,4,8,30,31 but some authors estimate that open reduction are not so risky compared to the functional challenge. 5,9,23 Some short series showed that modified Dunn procedure with femoral neck shortening and femoral head reduction and fixation seems to have a low rate of AVN with a good anatomic result.…”

Section: Discussionmentioning

confidence: 99%

“…5,9,23 Some short series showed that modified Dunn procedure with femoral neck shortening and femoral head reduction and fixation seems to have a low rate of AVN with a good anatomic result. 32e34 In-situ fixation is considered as the most safe surgical technique regarding vascularization 30,32 but its functional result could be worse because of partial reduction of upper femoral deformity. Preoperative traction is not risky 8,35,36 or has no real benefit.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Is the femoral head dead or alive before surgery of slipped capital femoral epiphysis? Interest of perfusion Magnetic Resonance Imaging

Chambenois

Vialle

Hubert

2014

Journal of Clinical Orthopaedics and Trauma

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is the femoral head dead or alive before surgery of slipped capital femoral epiphysis? Interest of perfusion Magnetic Resonance Imaging

Chambenois

Vialle

Hubert

2014

Journal of Clinical Orthopaedics and Trauma

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“…Akut başlangıç, stabil olmayan kalçalar, zorlayıcı redüksiyon denenmesi, kayma şiddetinin fazla olması, femur boyun osteotomilerinin uygulanması, superolateral kadrana çivi veya tel yerleştirilmesi avasküler nekroz riskinin artmasına neden olmaktadır. [18,[21][22][23][24] Çalışmadaki hastaların hiçbirinde Hastaların takiplerinde kalça hareket açıklıkla-rında iyileşmenin olması kalça remodelasyonunun olumlu etkilendiğini düşündürmektedir. Yalnızca bir hastada klinik yakınma oluşturmayan CAM tipi femoroasetabüler sıkışma görüldü.…”

Section: Discussionunclassified

How effective is in situ pinning with single screw fixation in mildly or moderately slipped capital femoral epipyhysis?

Cobanoglu

Çullu

İlhan

2014

Eklem Hastalik Cerrahisi

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Amaç: Bu çalışmada hafif ve orta şiddetli femur başı epifiz kaymasının (FBEK) tek vida ile olduğu pozisyonda tespitin sonuçları değerlendirildi. Hastalar ve yöntemler: Kronik stabil FBEK olan 15 hastanın (11 erkek, 4 kız; ort. yaş 12 yıl; dağılım 9-15 yıl) 18 kalçası tek vida ile olduğu pozisyonda tespit edildi. Acil immobilizasyon ve internal tespit uygulandı. Sonuçlar Heyman Herndon'un klinik ve Boyer'in radyolojik sınıflandırma sistemi ile değerlendirildi. Bulgular: Ortalama takip süresi 56 ay idi. Ortalama kayma açısı 38°, ortalama vücut kütle indeksi (VKİ) 26 kg/m 2 idi. Ameliyat öncesi dönemde ortalama kalça fleksiyon, iç ve dış rotasyon sırasıyla 94°, 9°, 59° ve ameliyat sonrası ortalama kalça fleksiyon, iç ve dış rotasyon sırasıyla 120°, 28°, 56° idi. Sonuçlar Heyman Herndon'un klinik ve Boyer'in radyolojik sınıflandırma sistemine göre tam olarak başa-rılıydı. Tüm hastalarda Trendelenburg testi negatifti. Bir olguda yakınma oluşturmayan CAM tipi femoroasetabüler sıkışma belirlendi, bir olguda FBEK olan tarafta, cerrahi tedavi edilen femur cisim kırığı öyküsü ve ekstremiteler arası uzunluk farkı vardı. Sonuç: Çalışmada hafif ve orta şiddetli kronik stabil femur başı epifiz kayması hastalarında redüksiyon uygulanmadan olduğu pozisyonda tek vida ile tespitin klinik ve radyolojik olarak başarılı sonuçları elde edildi. Orta dönem izlemde artroz ve sıkışma sendromuna bağlı klinik bulgular görülmedi.Anahtar sözcükler: Redüksiyon; tek vida ile tespit; femur başı epifiz kayması.Objectives: This study aims to evaluate the outcomes of mild and moderate slipped capital femoral epiphysis (SCFE) treated with in situ pinning. Patients and methods: Eighteen hips of 15 patients (11 boys, 4 girls; mean age 12 years; range 9 to 15 years) with chronic stable SCFE were treated with in situ pinning. Immediate immobilization and internal fixation were applied. The results were evaluated according to Heyman Herndon's clinical and Boyer's radiologic classification system. Results: The mean follow-up was 56 months. The mean slipping angle was 38°, while the mean body mass index was 26 kg/m 2 . The mean preoperative hip flexion, internal and external rotation were respectively 94°, 9°, 59° and the mean postoperative hip flexion, internal and external rotation were 120°, 28°, 56°, respectively. The results were completely successful according to the Heyman Herndon's clinical and Boyer's radiologic classification system. The Trendelenburg test was negative in all patients. There was an asymptomatic CAM-type femoroacetabular impingement in one case, while history of femoral shaft fracture treated with surgically in the SCFE side and limb length discrepancy in one case. Conclusion: In this study, we obtained successful clinical and radiological results of fixation with in situ pinning in patients with chronic stable mildly or moderately slipped capital femoral epiphysis without reduction. There were no clinical signs related to arthrosis and impingement syndrome in mid-term follow-up.

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“…The mean age of patients in whom SCFE occurs is 12 years old for girls and 14 years old for boys. This pathology is characterized, most often, by a progressive posterior displacement of capital femoral epiphysis from the femoral neck [1]. The femoral head remains trapped in the acetabulum.…”

Section: Introductionmentioning

confidence: 99%

The progressive longitudinal traction reduction of unstable slipped capital femoral epiphysis: Preliminary results in 11 patients

Thomsen¹,

Vialle²,

Maillet³

et al. 2007

Journal of Children's Orthopaedics

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Purpose Unstable slipped capital femoral epiphysis is rare, but is frequently associated with avascular necrosis. The rapid and complete reduction of the epiphysis displacement was shown to be responsible for this complication. We present the preliminary results of a progressive reduction technique of epiphysis displacement. Methods A total of 11 patients treated using progressive traction and internal fixation were reviewed retrospectively. Only children who underwent clinical and radiological follow-up for at least 18 months were included in this study to detect avascular necrosis. Results The mean posterior displacement of the femoral head was 67°and mean traction duration was 13 days. Of the patients, 2 had cutaneous problems requiring traction interruption, one on day 5 and the other on day 9. The mean residual slip was 16°and 3 patients had complete or partial avascular necrosis well tolerated at the final follow-up. Conclusion Our experience showed that if traction is supported for more than 2 weeks, a good correction of the epiphysis displacement can be obtained. Our short series does not allow affirmation of the superiority of our therapeutic strategy, especially with regards to avascular necrosis of the femoral head.

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Pinning in slipped capital femoral epiphysis: long-term follow-up study

Cited by 10 publications

References 30 publications

Is the femoral head dead or alive before surgery of slipped capital femoral epiphysis? Interest of perfusion Magnetic Resonance Imaging

Is the femoral head dead or alive before surgery of slipped capital femoral epiphysis? Interest of perfusion Magnetic Resonance Imaging

How effective is in situ pinning with single screw fixation in mildly or moderately slipped capital femoral epipyhysis?

The progressive longitudinal traction reduction of unstable slipped capital femoral epiphysis: Preliminary results in 11 patients

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