Betz R R, Steel H H, Emper W D, Huss G K, Clancy M
Shriners Hospitals for Crippled Children, Philadelphia, Pennsylvania 19152.
J Bone Joint Surg Am. 1990 Apr;72(4):587-600.
Thirty-two patients (thirty-seven hips) who had a so-called acute-on-chronic or chronic slipped capital femoral epiphysis were treated with traction for relief of symptoms and then with immobilization in a spica cast for eight to sixteen weeks. The disappearance on radiographs of a metaphyseal juxtaphyseal radiolucency, rather than closure of the physis, was used as the criterion for removing the cast. In one (3 per cent) of the thirty-seven hips, the slip progressed; possibly this could have been prevented by keeping the cast on for a longer period of time. Narrowing of the cartilage space was seen after treatment in a cast in seven (19 per cent) of the thirty-seven hips. In five of these seven hips, this was true chondrolysis; in one, the diagnosis of chondrolysis had been apparent before treatment. Avascular necrosis did not develop as a result of treatment in any patient. Treatment in a spica cast should be considered as an alternative for patients who have an acute-on-chronic or chronic slipped capital femoral epiphysis.
32例（37髋）患有所谓急性-on-慢性或慢性股骨头骨骺滑脱的患者接受了牵引治疗以缓解症状，随后在髋人字石膏固定8至16周。以干骺端邻骨骺透亮区在X线片上消失而非骨骺闭合作为拆除石膏的标准。在37髋中的1髋（3%），滑脱进展；或许通过延长石膏固定时间可预防此情况。在37髋中的7髋（19%）经石膏治疗后可见软骨间隙变窄。在这7髋中的5髋，这是真正的软骨溶解；在1髋中，软骨溶解在治疗前诊断就已明确。没有患者因治疗而发生缺血性坏死。对于患有急性-on-慢性或慢性股骨头骨骺滑脱的患者，应考虑髋人字石膏治疗作为一种替代方法。
