Surgical hip dislocation in treatment of slipped capital femoral epiphysis
| Autor: | Alessandro Massè, Ahmed Akar, Eissa Ragheb, Tarek M. Abd El-Ghaffar, Alessandro Aprato, Yousef Gad, Mohammed Elmarghany, Mahmoud Seddik |
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| Rok vydání: | 2016 |
| Předmět: |
musculoskeletal diseases
medicine.medical_specialty Avascular necrosis Surgical hip dislocation Osteoarthritis 03 medical and health sciences Femoral head 0302 clinical medicine lcsh:Orthopedic surgery medicine Deformity Orthopedics and Sports Medicine SCFE 030222 orthopedics Hip Trochanter business.industry 030229 sport sciences medicine.disease Surgery lcsh:RD701-811 medicine.anatomical_structure Epiphysis Harris Hip Score Original Article medicine.symptom Slipped capital femoral epiphysis business |
| Zdroj: | SICOT-J SICOT-J, Vol 3, p 10 (2017) |
| ISSN: | 2426-8887 |
| Popis: | Background: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666–679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI) [Leunig M, Slongo T, Ganz R (2008) Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis. Instr Course Lect 57, 499–507]. Objective: The primary aim of our study was to report the results of the technique of capital realignment with Ganz surgical hip dislocation and its reproducibility to restore hip anatomy and function. Patients and methods: This prospective case series study included 30 patients (32 hips, 13 left (Lt) hips, 19 right (Rt) hips) with stable chronic slipped capital femoral epiphysis (SCFE) after surgical correction with a modified Dunn procedure. This study included 22 males and eight females. The mean age of our patients was 14 years (10–18 years). The mean follow-up period was 14.5 months (6–36 months). Results: Thirty hips had excellent and good clinical and radiographic outcomes with respect to hip function and radiographic parameters. Two patients had fair to poor clinical outcome including three patients who developed Avascular Necrosis (AVN). The difference between those who developed AVN and those who did not develop AVN was statistically significant in postoperative clinical scores (p = 0.0000). The mean slip angle of the femoral head was 52.5° ± 14.6 preoperatively and was corrected to a mean value of 5.6° ± 8.2° with mean correction of 46.85° ± 14.9° (p = 0.0000). The mean postoperative alpha angle was 51.15° ± 4.2° with mean correction of 46.70 ± 14.20 (p = 0.0000). In our series, the mean postoperative Harris hip score (HHS) was (96.16 ± 9.7) and the mean improvement was (29.6 ± 9.6) (p = 0.0000). Conclusions: The modified Dunn procedure allows to restore the normal proximal femoral anatomy by complete correction of the slip angle. This technique may reduce the probability of secondary osteoarthritis and femoroacetabular cam impingement. |
| Databáze: | OpenAIRE |
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