Sheffield Children's Hospital, Western Bank, Sheffield S10 2TH, UK.
Bone Joint J. 2013 Mar;95-B(3):424-9. doi: 10.1302/0301-620X.95B3.30113.
We present our experience of the modified Dunn procedure in combination with a Ganz surgical dislocation of the hip to treat patients with severe slipped capital femoral epiphysis (SCFE). The aim was to prospectively investigate whether this technique is safe and reproducible. We assessed the degree of reduction, functional outcome, rate of complications, radiological changes and range of movement in the hip. There were 28 patients with a mean follow-up of 38.6 months (24 to 84). The lateral slip angle was corrected by a mean of 50.9° (95% confidence interval 44.3 to 57.5). The mean modified Harris hip score at the final follow-up was 89.1 (sd 9.0) and the mean Non-Arthritic Hip score was 91.3 (sd 9.0). Two patients had proven pre-existing avascular necrosis and two developed the condition post-operatively. There were no cases of nonunion, implant failure, infection, deep-vein thrombosis or heterotopic ossification. The range of movement at final follow-up was nearly normal. This study adds to the evidence that the technique of surgical dislocation and anatomical reduction is safe and reliable in patients with SCFE.
我们介绍了改良 Dunn 手术联合 Ganz 髋关节外科脱位治疗严重股骨颈滑脱（SCFE）患者的经验。目的是前瞻性研究该技术是否安全且可重复。我们评估了复位程度、功能结果、并发症发生率、影像学变化和髋关节活动范围。共有 28 例患者，平均随访 38.6 个月（24 至 84）。外侧滑移角度平均纠正 50.9°（95%置信区间 44.3 至 57.5）。末次随访时改良 Harris 髋关节评分平均为 89.1（sd 9.0），非关节炎髋关节评分平均为 91.3（sd 9.0）。有 2 例患者术前证实存在缺血性坏死，2 例术后发生该疾病。无骨不连、植入物失败、感染、深静脉血栓形成或异位骨化病例。末次随访时的活动范围接近正常。本研究增加了证据，表明外科脱位和解剖复位技术在 SCFE 患者中是安全可靠的。
