Department of Orthopaedic Surgery, Haukeland University Hospital, Norway.
Acta Orthop. 2011 Jun;82(3):333-8. doi: 10.3109/17453674.2011.579520. Epub 2011 Apr 20.
Slipped capital femoral epiphysis (SCFE) is often treated by surgical fixation; however, no agreement exists regarding technique. We analyzed the outcome of in situ fixation with Steinmann pins.
All 67 subjects operated for slipped capital femoral epiphysis at Haukeland University Hospital during the period 1990-2007 were included. All were treated by in situ fixation with 2 or 3 parallel Steinmann pins (8 mm threads at the medial end). The follow-up evaluation consisted of clinical examination and hip radiographs. Radiographic outcome was based on measurements of slip progression, growth of the femoral neck, leg length discrepancy, and signs of avascular necrosis and chondrolysis.
67 subjects (41 males) were operated due to unilateral slips (n = 47) or bilateral slips (n = 20). Mean age at time of diagnosis was 13 (7.2-16) years. Mean age at follow-up was 19 (14-30) years, with a mean postoperative interval of 6.0 (2-16) years. The operated femoral neck was 9% longer at skeletal maturity than at surgery, indicating continued growth of the femoral neck. At skeletal maturity, 12 subjects had radiographic features suggestive of a previous asymptomatic slip of the contralateral hip. The total number of bilateral cases of SCFE was 32, i.e half of the children had bilateral SCFE. 3 subjects required additional surgery and mild avascular necrosis of the femoral head was seen in 1 patient. None had slip progression or chondrolysis.
In situ pinning of SCFE with partly threaded Steinmann pins appears to be a feasible and safe method, with few complications. The technique allows further growth of the femoral neck.
股骨颈骨骺滑脱（SCFE）常采用手术固定治疗；但目前对于具体的术式尚未达成共识。本研究分析了经皮斯氏针内固定术的治疗效果。
纳入 1990 年至 2007 年期间在豪克兰德大学医院接受手术治疗的 67 例 SCFE 患者。所有患者均采用 2 或 3 枚平行斯氏针（内侧 8mm 螺纹）行原位固定。随访评估包括临床检查和髋关节 X 线片。影像学结果基于滑脱进展、股骨颈生长、肢体长度差异以及缺血性坏死和软骨溶解的迹象进行评估。
67 例患者（41 例男性）中，单侧滑脱 47 例，双侧滑脱 20 例。诊断时的平均年龄为 13 岁（7.2-16 岁）。随访时的平均年龄为 19 岁（14-30 岁），术后平均间隔时间为 6.0 年（2-16 年）。骨骼成熟时，患侧股骨颈比手术时长 9%，表明股骨颈仍在生长。骨骼成熟时，12 例患者对侧髋关节出现先前无症状的滑脱影像学表现。共有 32 例患者为双侧 SCFE，即一半的儿童存在双侧 SCFE。3 例患者需要进一步手术，1 例患者出现轻度股骨头缺血性坏死。无一例患者出现滑脱进展或软骨溶解。
经皮斯氏针内固定术治疗 SCFE 采用部分螺纹斯氏针，是一种可行且安全的方法，并发症较少。该技术允许股骨颈进一步生长。
