Intraartikuläre Korrektureingriffe bei jugendlicher Hüftkopfepiphysenlösung*
| Autor: | Gekeler J, Kneer W |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Decompression business.industry medicine.medical_treatment Osteotomy medicine.disease Surgery medicine.anatomical_structure Intra articular Epiphysis Epiphysiolysis medicine Orthopedics and Sports Medicine Femur business Slipped capital femoral epiphysis Femoral neck |
| Zdroj: | Zeitschrift für Orthopädie und ihre Grenzgebiete. 122:142-149 |
| ISSN: | 1438-941X 0044-3220 |
| DOI: | 10.1055/s-2008-1044598 |
| Popis: | Treatment of severely slipped capital femoral epiphysis depends on the individual pathoanatomic and pathophysiologic conditions. Since the femoral neck vessels remain intact in chronic slip, they should be preserved whenever possible. Bilateral chondrolysis developed in 1 of our 9 cervical osteotomy patients. Long-term radiologic and clinical findings after a cervical osteotomy do not differ appreciably from those after an Imhauser osteotomy, in some cases, with incomplete realignment of the femoral head-acetabulum relation. Apparently, not only the "quantitative" factor but also the "qualitative" factor plays an important role in epiphyseal separation. By contrast, severe acute slip is a severe irritation of the joint accompanied by intra-articular bleeding and rupture of the femoral neck vessels. Good results are achieved after immediate operative decompression, controlled reduction, and stable fixation of the epiphysis, providing anatomic realignment of the femoral head-acetabulum relation is not forced, but rather carried out only to the limit of tolerance without leverage maneuver and under moderate traction and vision. Epiphyseal necrosis developed after conventional open reduction in 2 of our 16 patients with acute slip. No cases of epiphyseal necrosis have been observed to date in any of our patients (N = 5) treated with this new technique of controlled reduction (i.e., partial reduction in "acute chronic slip"). |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|