Accadbled F, Murgier J, Delannes B, Cahuzac J P, de Gauzy J Sales
Department of Orthopaedics, Children's Hospital, CHU de Toulouse, France.
J Child Orthop. 2017 Apr;11(2):107-109. doi: 10.1302/1863-2548-11-160282.
Management of moderately displaced slipped capital femoral epiphysis (SCFE) is debated, mostly because of the risks related to open reduction on one hand, and subsequent evolution toward femoroacetabular impingement (FAI) on the other.
All SCFE cases treated with fixation (ISF) and a minimum of ten years of follow-up beyond skeletal maturity were analysed in a retrospective multicentre study. Coxometry parameters were measured. Long-term results of ISF were meanwhile analysed at our Institution.
A total of 222 patients were included. Patient reported outcome measurements were related to the severity of the initial slip. It suggested a 35.5° threshold for slip angle beyond which FAI was more frequent. Only slight remodelling at the head-neck junction is to be expected.
Based on these findings, it seems reasonable to perform ISF only in SCFE with a slip angle below 35°.
对于中度移位的股骨头骨骺滑脱（SCFE）的治疗存在争议，主要是因为一方面与切开复位相关的风险，另一方面是随后发展为股骨髋臼撞击症（FAI）的风险。
在一项回顾性多中心研究中，分析了所有接受内固定（ISF）治疗且骨骼成熟后至少随访十年的SCFE病例。测量了髋臼测量参数。同时在我们机构分析了ISF的长期结果。
共纳入222例患者。患者报告的结局指标与初始滑脱的严重程度相关。结果表明，滑脱角超过35.5°时，FAI更为常见。预计头颈交界处只会有轻微重塑。
基于这些发现，仅对滑脱角小于35°的SCFE进行ISF似乎是合理的。
