Massè Alessandro, Aprato Alessandro, Grappiolo Guido, Turchetto Luigino, Campacci Antonio, Ganz Reinhold
Pelvic Unit, San Luigi Hospital of Orbassano, II Faculty of Medicine and Surgery, University of Turin, Orbassano, Italy.
Hip Int. 2012 Mar-Apr;22(2):137-44. doi: 10.5301/HIP.2012.9208.
Controversies exist regarding the best treatment for slipped capital femoral epiphysis (SCFE). Subcapital anatomical reorientation of the epiphysis by surgical dislocation and a retinacular soft tissue flap has been described recently as an effective approach. We evaluated the clinical and radiographic efficacy of this technique and compared these to published results. A series of 20 SCFE (18 stable, 2 unstable) treated by subcapital re-orientation through surgical hip dislocation and an extended retinacular soft tissue flap was reviewed retrospectively. Preoperatively and at most recent follow-up, patients were clinically examined with regard to pain and function according to the Harris hip score and to the Western Ontario and McMaster universities (WOMAC) score. Radiological examination included measurement of preoperative and postoperative anteroposterior (AP) and lateral (L) Southwick angles; and at follow-up the alpha angle was measured. The average follow-up time was 24 months. The mean WOMAC score was 2.80 post-operatively. The mean pre-operative slip angle was 40.2 degrees on the AP view and 50.65 degrees on the lateral view. Post-operatively, the mean values were 7,20 degrees on the AP view and 9,45 degrees on the lateral view. The mean post-operative average alpha angle was 43,11 degrees. No cases of avascular necrosis were seen. Our short term clinical and radiographic results are similar to outcomes published in the recent literature. The small number of technical complications appears favourable considering the surgical complexity of the procedure, and our technique offers clear advantages in treating these complex deformities.
关于股骨头骨骺滑脱（SCFE）的最佳治疗方法存在争议。最近，通过手术脱位和支持带软组织瓣对骨骺进行股骨头下解剖重新定位被描述为一种有效的方法。我们评估了该技术的临床和影像学疗效，并将其与已发表的结果进行了比较。回顾性分析了一系列20例SCFE患者（18例稳定型，2例不稳定型），这些患者通过手术髋关节脱位和延长的支持带软组织瓣进行股骨头下重新定位治疗。术前和最近一次随访时，根据Harris髋关节评分和西安大略和麦克马斯特大学（WOMAC）评分对患者的疼痛和功能进行临床检查。放射学检查包括术前和术后前后位（AP）和侧位（L）Southwick角的测量；随访时测量α角。平均随访时间为24个月。术后平均WOMAC评分为2.80。术前AP位平均滑脱角为40.2度，侧位为50.65度。术后，AP位平均值为7.20度，侧位为9.45度。术后平均α角为43.11度。未发现缺血性坏死病例。我们的短期临床和影像学结果与最近文献中发表的结果相似。考虑到手术的复杂性，少量的技术并发症似乎是有利的，并且我们的技术在治疗这些复杂畸形方面具有明显优势。
