Nguyen D, Morrissy R T
Department of Orthopaedics, Scottish Rite Children's Medical Center, Atlanta, Georgia.
J Pediatr Orthop. 1990 May-Jun;10(3):341-6. doi: 10.1097/01241398-199005000-00009.
In pinning a slipped capital femoral epiphysis (SCFE), the position of the pin within the center of the femoral head is important for two reasons. The pin may disrupt the lateral epiphyseal artery and cause avascular necrosis (AVN), or pin penetration in certain locations may go unrecognized on radiographs. To place the pin accurately, the surgeon must be aware of where the femoral head lies in relation to the femoral neck and the shaft. Radiographs of models and of patients in various positions support the view that the femoral head in most cases of chronic SCFE rotates around the axis of the femoral neck and does not slip inferiorly. Therefore, the starting point for an in situ fixation device is the anterior femoral neck, the exact location depending on the amount of slipping.
在固定股骨头骨骺滑脱（SCFE）时，钢针在股骨头中心内的位置很重要，原因有两个。钢针可能会破坏外侧骨骺动脉并导致缺血性坏死（AVN），或者在某些位置的钢针穿透在X线片上可能无法被识别。为了准确放置钢针，外科医生必须清楚股骨头相对于股骨颈和股骨干的位置。模型和处于不同体位患者的X线片支持这样的观点，即在大多数慢性SCFE病例中，股骨头围绕股骨颈轴线旋转，而不会向下滑移。因此，原位固定装置的起始点是股骨颈前部，确切位置取决于滑移量。
