Plötz G M, Hippe P, Hassenpflug J
Orthopädische Universitätsklinik Kiel.
Z Orthop Ihre Grenzgeb. 1998 Nov-Dec;136(6):534-41. doi: 10.1055/s-2008-1045182.
In the operative therapy of slipped capital femoral epiphysis, a controversial discussion exists about the sense of a simultaneous stabilization of both epiphyseal plates and about the correct time of removing the implants. We show the epikrisis of two patients to demonstrate our therapy regimen: in the first case the implants were removed too early. The consequence was a further slipping of the femoral epiphysis consecutive on both sides and the necessity of further surgery. In the other case we observed an outgrowing of the implant out of the epiphyseal plate by use of unthreaded wires. The growth plate was not closed. The femoral epiphysis was stabilized again, because an outgrowing compares to an implant removal at a too early stage. These two cases show our point of view. We recommend to stabilize both sides simultaneously with threaded wires and not to remove the implants before closure of the epiphyseal plate. Furthermore, we hold it advisable to perform a restabilization, when the implants grow out of the unclosed epiphyseal plate during adolescence.
在股骨头骨骺滑脱的手术治疗中，对于同时稳定两个骨骺板的意义以及取出植入物的正确时间存在争议。我们展示两例患者的病例报告以说明我们的治疗方案：第一例中植入物取出过早。结果是双侧股骨头骨骺进一步滑脱，有必要再次手术。在另一例中，我们观察到使用无螺纹钢丝时植入物从骨骺板中穿出。生长板未闭合。由于穿出情况相较于过早取出植入物，股骨头骨骺再次稳定。这两个病例表明了我们的观点。我们建议用带螺纹的钢丝同时稳定双侧，并且在骨骺板闭合前不要取出植入物。此外，我们认为当植入物在青春期从未闭合的骨骺板中穿出时，进行再次稳定是可取的。
