股骨头骨骺滑脱患者髋关节的亚临床双侧受累：一项多中心研究。
Subclinical bilateral involvement of the hip in patients with slipped capital femoral epiphysis: a multicentre study.
作者信息
Kohno Yusuke, Nakashima Yasuharu, Kitano Toshio, Nakamura Tomoyuki, Takamura Kazuyuki, Akiyama Mio, Hara Daisuke, Yamamoto Takuaki, Motomura Goro, Ohishi Masanobu, Hamai Satoshi, Yukihide Iwamoto
机构信息
Orthopaedic Surgery, Kyushu University, Fukuoka, Japan.
出版信息
Int Orthop. 2014 Mar;38(3):477-82. doi: 10.1007/s00264-013-2131-y. Epub 2013 Oct 11.
PURPOSE
This study was conducted to assess the posterior inclination of the contralateral femoral epiphysis in patients with unilateral slipped capital femoral epiphysis (SCFE).
METHODS
The posterior sloping angle (PSA) was measured using lateral radiographs in 67 patients with a unilateral SCFE and in 41 age-matched normal controls. A symptomatic epiphyseal slip was defined as the development of SCFE.
RESULTS
The contralateral PSA in SCFE patients was more widely distributed and significantly larger compared to controls (15.0° vs. 9.0°, p < 0.0001). Forty-seven hips (70.1%) had a PSA of greater than 12.8°, which was +2SD of the control hips. Of the 65 hips excluding the two cases with prophylactic pinning, 11 hips (16.9%) eventually developed a contralateral SCFE during adolescence and their PSA at the initial visit was significantly larger compared to patients without a contralateral SCFE (18.0° vs. 14.3°, p < 0.005) with a cutoff value of 19°.
CONCLUSIONS
These findings suggested the possibility of bilateral hip involvement in SCFE patients. Hips with greater degrees of PSA (> 19°) are likely to become symptomatic.
目的
本研究旨在评估单侧股骨头骨骺滑脱（SCFE）患者对侧股骨骨骺的后倾情况。
方法
使用侧位X线片测量67例单侧SCFE患者及41例年龄匹配的正常对照者的后倾角度（PSA）。有症状的骨骺滑脱定义为SCFE的发生。
结果
与对照组相比，SCFE患者的对侧PSA分布更广泛且显著更大（15.0°对9.0°，p < 0.0001）。47个髋关节（70.1%）的PSA大于12.8°，这是对照髋关节的+2标准差。在排除两例预防性穿针固定的65个髋关节中，11个髋关节（16.9%）在青春期最终发生了对侧SCFE，其初次就诊时的PSA与未发生对侧SCFE的患者相比显著更大（18.0°对14.3°，p < 0.005），临界值为19°。
结论
这些发现提示SCFE患者可能存在双侧髋关节受累。PSA程度较高（> 19°）的髋关节可能会出现症状。
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