Aronsson David D, Loder Randall T, Breur Gert J, Weinstein Stuart L
Department of Orthopedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT 05405, USA.
J Am Acad Orthop Surg. 2006 Nov;14(12):666-79. doi: 10.5435/00124635-200611000-00010.
Slipped capital femoral epiphysis is a common hip disorder in adolescents, with an incidence of 0.2 (Japan) to 10 (United States) per 100,000. The etiology is unknown, but biomechanical and biochemical factors play an important role. Symptoms at presentation include pain in the groin, thigh, or knee. Ambulatory patients also may present with a limp. Nonambulatory patients present with excruciating pain. The slipped capital femoral epiphysis is classified as stable when the patient can walk and unstable when the patient cannot walk, even with the aid of crutches. Because the epiphysis slips posteriorly, it is best seen on lateral radiographs. The treatment of choice for stable slipped capital femoral epiphysis is single-screw fixation in situ. This method has a high probability of long-term success, with minimal risk of complications. In the patient with unstable slipped capital femoral epiphysis, urgent hip joint aspiration followed by closed reduction and single- or double-screw fixation provides the best environment for a satisfactory result, while minimizing the risk of complications.
股骨头骨骺滑脱是青少年常见的髋关节疾病，发病率为每10万人中有0.2例（日本）至10例（美国）。病因不明，但生物力学和生化因素起重要作用。就诊时的症状包括腹股沟、大腿或膝盖疼痛。能行走的患者也可能出现跛行。不能行走的患者则表现为剧痛。当患者能够行走时，股骨头骨骺滑脱被分类为稳定型；当患者即使借助拐杖也无法行走时，则为不稳定型。由于骨骺向后滑脱，在侧位X线片上最易观察到。稳定型股骨头骨骺滑脱的首选治疗方法是原位单螺钉固定。这种方法长期成功的概率很高，并发症风险极小。对于不稳定型股骨头骨骺滑脱患者，紧急髋关节穿刺，随后进行闭合复位和单螺钉或双螺钉固定，可为获得满意结果提供最佳条件，同时将并发症风险降至最低。
