Witbreuk Melinda M E H, Bolkenbaas M, Mullender M G, Sierevelt I N, Besselaar P P
J Child Orthop. 2009 Oct;3(5):405-10. doi: 10.1007/s11832-009-0204-7. Epub 2009 Sep 26.
Patients with moderate and severe slipped capital femoral epiphysis (SCFE) develop osteoarthritis earlier in life in association with mechanical impingement.
To correct deformity and diminish impingement, we performed epiphysiodesis combined with an Imhauser intertrochanteric osteotomy (ITO) in moderate and severe slipped capital femoral epiphysis. We downgraded the angle of the head relative to the acetabulum into an angle corresponding to a mild slip or even an anatomical position. Our hypothesis is that the avoidance of anterior impingement at an early stage can prevent the development of osteoarthritis.
The results of 28 patients (32 hips) were evaluated. Outcome parameters were SF-36, Harris Hip Score, range of motion, Kellgren-Lawrence score, chondrolysis and avascular necrosis. After a median follow-up of 8 (range 2-25) years, the group was clinically, functionally and socially performing well. Radiologically, there was no sign of chondrolysis or avascular necrosis, and more than 80% of the patients did not show any signs of osteoarthritis.
Based on these results, we conclude that a one-stage Imhauser ITO combined with epiphysiodesis performed on patients with moderate and severe SFCE gives satisfactory results.
中重度股骨头骨骺滑脱（SCFE）患者会因机械撞击在生命早期就发展为骨关节炎。
为了矫正畸形并减少撞击，我们对中重度股骨头骨骺滑脱患者实施了骨骺固定术联合Imhauser转子间截骨术（ITO）。我们将股骨头相对于髋臼的角度降低至对应轻度滑脱甚至解剖位置的角度。我们的假设是早期避免前方撞击可预防骨关节炎的发展。
对28例患者（32髋）的结果进行了评估。结果参数包括SF-36、Harris髋关节评分、活动范围、Kellgren-Lawrence评分、软骨溶解和缺血性坏死。中位随访8年（范围2 - 25年）后，该组患者在临床、功能和社会方面表现良好。放射学检查显示，没有软骨溶解或缺血性坏死的迹象，超过80%的患者未表现出任何骨关节炎迹象。
基于这些结果，我们得出结论，对中重度SCFE患者实施一期Imhauser ITO联合骨骺固定术可取得满意效果。
