Vukasinović Zoran, Slavković Nemanja, Slavković Slobodan
Srp Arh Celok Lek. 2007 Jan-Feb;135(1-2):105-10.
Slipped capital femoral epiphysis is well known disorder of the hip in adolescents, which is characterized by displacement of the capital femoral epiphysis from the metaphysis through the physeal plate. The incidence of slipped capital femoral epiphysis is about 5-8 cases per 100,000 adolescents. Etiology of slipped capital femoral epiphysis is still unknown, but this disorder is probably combination of genetic, hormonal and mechanical factors. On the basis of patient's history, physical examination, and radiographs, slipped capital femoral epiphysis can be classified as acute or chronic. Two most severe complications of slipped capital femoral epiphysis are avascular necrosis and chondrolysis. Avascular necrosis is more commonly associated with the acute slips when the lateral epiphyseal vessels are disrupted. In chronic slips, avascular necrosis can occur as a result of treatment. Chondrolysis or cartilage necrosis can occur in untreated slips, but is often associated with spica cast imobilization or penetratation of the internal fixation screws into the joint space. The final outcome of avascular necrosis and chondrolysis is extremly poor for a patient. Therefore, the baseline of management of slipped capital femoral epiphysis is treatment by adequate techniques that have high rate of success with minimal risk of complications.
股骨头骨骺滑脱是青少年常见的髋关节疾病,其特征是股骨头骨骺通过骺板从干骺端移位。股骨头骨骺滑脱的发病率约为每10万名青少年中有5 - 8例。股骨头骨骺滑脱的病因尚不清楚,但这种疾病可能是遗传、激素和机械因素共同作用的结果。根据患者的病史、体格检查和X线片,股骨头骨骺滑脱可分为急性或慢性。股骨头骨骺滑脱最严重的两种并发症是缺血性坏死和软骨溶解。缺血性坏死更常与急性滑脱相关,此时外侧骨骺血管被破坏。在慢性滑脱中,缺血性坏死可能是治疗的结果。软骨溶解或软骨坏死可发生在未经治疗的滑脱中,但通常与髋人字石膏固定或内固定螺钉穿入关节间隙有关。缺血性坏死和软骨溶解对患者的最终预后极差。因此,股骨头骨骺滑脱治疗的基本要求是采用成功率高、并发症风险最小的适当技术进行治疗。