Hosseinzadeh Shayan, Kiapour Ata M, Maranho Daniel A, Emami Seyed Alireza, Portilla Gabriela, Kim Young-Jo, Novais Eduardo N
Department of Orthopaedic Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Hospital Sírio-Libanês, Brasilia, Federal District, Brazil.
J Child Orthop. 2020 Jun 1;14(3):184-189. doi: 10.1302/1863-2548.14.200010.
To compare the 3D morphology of the metaphyseal fossa among mild, moderate and severe stable slipped capital femoral epiphysis (SCFE) and normal hips.
We identified pelvic CT of 51 patients (55% male; mean 12.7 years (sd 1.9; 8-15)) with stable SCFE. In all, 16 of 51 hips (31%) had mild, 14 (27%) moderate and 21 (41%) severe SCFE. A total of 80 patients (50% male; mean age 11.5 years (sd 2.3; 8 to 15)) with normal hips who underwent pelvic CT due to abdominal pain made up the control cohort. CT scans were segmented, and the femur was reformatted using 3D software. We measured the metaphyseal fossa depth, width, length and surface area after the epiphysis was subtracted from the metaphysis in the 3D model.
The metaphyseal fossa width was significantly larger in severe (adjusted difference: 6.9%; 95% confidence interval (CI) 2.1 to 11.8; p = 0.001), moderate (6.5%; 95% CI 0.8 to 12.2; p = 0.02) and mild SCFE (6.2%; 95% CI 0.8 to 11.6; p = 0.01), in comparison with normal hips. Severe SCFE showed larger fossa length compared with mild SCFE (6.8%; 95% CI 0.6 to 13.0; p = 0.02) and normal hips (6.0%; 95% CI 1.4 to 10.6; p = 0.004). The fossa surface area was larger in severe (3.5%; 95% CI 1.3 to 5.7; p < 0.001) and moderate SCFE (2.7%; 95% CI 0.1 to 5.2; p = 0.03) when compared with normal hips. There were no differences in fossa depth between SCFE and normal hips.
The metaphyseal fossa is wider and more extensive but not deeper in hips with moderate and severe SCFE in comparison with normal hips. Although hips with severe SCFE had larger length and surface area than mild SCFE hips, further research is needed to clarify whether enlargement of the metaphyseal fossa is a consequence of slip progression.
III.
比较轻度、中度和重度稳定型股骨头骨骺滑脱（SCFE）以及正常髋关节的干骺端窝的三维形态。
我们确定了51例稳定型SCFE患者（55%为男性；平均年龄12.7岁（标准差1.9；8 - 15岁））的骨盆CT影像。在这51例髋关节中，16例（31%）为轻度SCFE，14例（27%）为中度SCFE，21例（41%）为重度SCFE。共有80例因腹痛接受骨盆CT检查的正常髋关节患者（50%为男性；平均年龄11.5岁（标准差2.3；8至15岁））组成了对照组。对CT扫描进行分割，并使用三维软件对股骨进行重新格式化。在三维模型中，从干骺端减去骨骺后，我们测量了干骺端窝的深度、宽度、长度和表面积。
与正常髋关节相比，重度（校正差异：6.9%；95%置信区间（CI）2.1至11.8；p = 0.001）、中度（6.5%；95% CI 0.8至12.2；p = 0.02）和轻度SCFE（6.2%；95% CI 0.8至11.6；p = 0.01）的干骺端窝宽度显著更大。与轻度SCFE（6.8%；95% CI 0.6至13.0；p = 0.02）和正常髋关节（6.0%；95% CI 1.4至10.6；p = 0.004）相比，重度SCFE的窝长度更大。与正常髋关节相比，重度（3.5%；95% CI 1.3至5.7；p < 0.001）和中度SCFE（2.7%；95% CI 0.1至5.2；p = 0.03）的窝表面积更大。SCFE和正常髋关节之间的窝深度没有差异。
与正常髋关节相比，中度和重度SCFE髋关节的干骺端窝更宽且范围更大，但深度没有增加。虽然重度SCFE髋关节的长度和表面积比轻度SCFE髋关节大，但需要进一步研究以阐明干骺端窝扩大是否是滑脱进展的结果。
III级。
