Barrios Carlos, Blasco M Angeles, Blasco M Carmen, Gascó José
Orthopaedics and Trauma Unit, Department of Surgery, Valencia University Medical School, Valencia, Spain.
J Pediatr Orthop. 2005 Jul-Aug;25(4):445-9. doi: 10.1097/01.bpo.0000158811.29602.a5.
Different anatomic parameters were measured on radiographs of the healthy hip of 47 patients with unilateral slipped capital femoral epiphysis (SCFE). Data were compared with those from 36 hips of 23 healthy adolescents matched in age, weight, and stature. During 5 years of follow-up, eight patients with unilateral SCFE developed slippage of the contralateral side. Patients with unilateral SCFE had a lower physis-diaphysis angle and a larger angle of physeal sloping in the AP view than controls, reflecting a more vertical orientation of the capital femoral physis. In the axial view, control patients had a mean value of the posterior sloping angle of the capital femoral physis of 5 degrees, compared with 12 degrees in unilateral SCFE cases and 18 degrees in patients developing bilateral SCFE. The risk of developing bilateral disease can be predicted by measuring hip morphometric parameters, the most important factor being the posterior sloping of capital femoral physis in the axial view. Prophylactic pinning of the healthy contralateral side should be strongly recommend only in patients with unilateral SCFE showing an axial posterior sloping angle of the physis of over 12 degrees.
对47例单侧股骨头骨骺滑脱（SCFE）患者健康髋关节的X线片测量了不同的解剖参数。将数据与23名年龄、体重和身高匹配的健康青少年的36个髋关节的数据进行比较。在5年的随访期间，8例单侧SCFE患者对侧出现了滑脱。与对照组相比，单侧SCFE患者在前后位（AP）视图中干骺端-骨干角较小，骨骺倾斜角较大，这反映了股骨头骨骺的方向更垂直。在轴位视图中，对照组患者股骨头骨骺后倾斜角的平均值为5度，单侧SCFE病例为12度，双侧SCFE患者为18度。通过测量髋关节形态学参数可以预测双侧疾病的发生风险，最重要的因素是轴位视图中股骨头骨骺的后倾斜。仅在单侧SCFE患者的骨骺轴位后倾斜角超过12度时，才应强烈建议对健康对侧进行预防性固定。
