Kartenbender K, Cordier W, Katthagen B D
Department of Orthopaedics, Städtische Kliniken Dortmund, Germany.
J Pediatr Orthop. 2000 Nov-Dec;20(6):749-56. doi: 10.1097/00004694-200011000-00010.
The management of severe slipped capital femoral epiphysis (SCFE) is still controversial, because of a lack of long-term follow-up studies. Thirty-five patients (39 hips) with severe slipped capital femoral epiphysis, treated by corrective intertrochanteric Imhäuser osteotomy, were clinically and radiographically reexamined. The average age at the operation was 13.7 years (range, 8-17 years) and the reexamination was at an average of 23.4 years (range, 19-27 years) after the operation. At reexamination, 77% of patients were rated good to excellent clinically and 67% had good or excellent radiological results by the Southwick classification. Three patients had severe degenerative arthritic changes, and two patients developed avascular necrosis. We conclude that the Imhäuser osteotomy should be performed in severe deformities (>40 degrees gliding angle) associated with poor function. Because other studies show good long-term results after in situ pinning only, the indication for Imhauser osteotomy should be made carefully depending on clinical and radiological findings.
由于缺乏长期随访研究，重度股骨头骨骺滑脱（SCFE）的治疗仍存在争议。对35例（39髋）接受转子间Imhäuser截骨矫正治疗的重度股骨头骨骺滑脱患者进行了临床和影像学复查。手术时的平均年龄为13.7岁（范围8 - 17岁），术后复查平均在术后23.4年（范围19 - 27岁）。复查时，77%的患者临床评定为良好至优秀，根据Southwick分类，67%的患者影像学结果为良好或优秀。3例患者出现严重退行性关节病变，2例患者发生缺血性坏死。我们得出结论，Imhäuser截骨术应在伴有功能不良的严重畸形（滑移角>40度）中实施。由于其他研究仅显示原位穿针固定后有良好的长期效果，因此应根据临床和影像学检查结果谨慎确定Imhäuser截骨术的适应症。
