Chatziravdeli V, Stefanou M, Pilichou A, Krallis P, Anastasopoulos J
2 Orthopaedic Department, Papageorgiou General Hospital, Thessaloniki, Greece.
2 Department of Pediatric Orthopaedic Surgery, Children's Hospital "Agia Sofia", Athens, Greece.
Hippokratia. 2019 Oct-Dec;23(4):165-168.
Slipped capital femoral epiphysis (SCFE) is a condition commonly affecting adolescents. It is scarcely reported in children under ten years of age, but it can be debilitating when misdiagnosed. Our purpose was to report the incidence and treatment methods of SCFE that were applied in our institution in children under the age of ten.
We retrospectively reviewed the records of patients with SCFE treated between 2007-2018 and excluded those older than ten years old. During the study period, 46 patients (49 hips) were diagnosed with SCFE, of whom nine patients (11 hips) were children younger than ten years old. The mean age at presentation was 8.25 years. The classification was made according to the Southwick slip angle and stability of the slip. Comorbidities and body mass index (BMI) were registered. There were nine milds, one moderate, and one severe slip. All but one case were stable. All the children were above the 97 percentile BMI for age. Three patients suffered from metabolic disease. Kirschner wire (K-wire) fixation was used in five hips and fixation with a single partially threaded cannulated screw (CS) in six. Only two complications that required intervention were recorded, one K-wire loosening, and one K-wire mechanical failure. The mean follow-up time was 40.1 (range: 10-74) months and included eight of the nine patients. They were monitored for pain, range of motion, avascular necrosis of the femoral head, and slip progression.
The diagnosis of SCFE should be considered in overweight children under the age of ten, with hip-related clinical manifestations. Treatment in this young group of patients can be demanding. K-wire and partially threaded CS fixation both provide stability and accommodate the femoral head's future growth. The use of K-wire fixation is recommended at a very young age (6-8 years of age). Orthopedic surgeons have to be aware of the increased risk of hardware-related complications when using K-wires that may have to be addressed surgically. HIPPOKRATIA 2019, 23(4): 165-168.
股骨头骨骺滑脱（SCFE）是一种常见于青少年的病症。在10岁以下儿童中鲜有报道，但误诊时可能会导致功能障碍。我们的目的是报告我院对10岁以下儿童应用的SCFE发病率及治疗方法。
我们回顾性分析了2007年至2018年间接受治疗的SCFE患者记录，并排除了10岁以上的患者。在研究期间，46例患者（49髋）被诊断为SCFE，其中9例患者（11髋）为10岁以下儿童。就诊时的平均年龄为8.25岁。根据Southwick滑脱角和滑脱稳定性进行分类。记录合并症和体重指数（BMI）。有9例轻度、1例中度和1例重度滑脱。除1例病例外，所有病例均稳定。所有儿童的BMI均高于同年龄的第97百分位数。3例患者患有代谢性疾病。5髋采用克氏针（K针）固定，6髋采用单枚部分螺纹空心钉（CS）固定。仅记录到2例需要干预的并发症，1例K针松动，1例K针机械故障。平均随访时间为40.1（范围：10 - 74）个月，9例患者中的8例纳入随访。对他们进行疼痛、活动范围、股骨头缺血性坏死和滑脱进展的监测。
对于10岁以下有髋关节相关临床表现的超重儿童，应考虑SCFE的诊断。对这一年轻患者群体的治疗可能具有挑战性。K针和部分螺纹CS固定均能提供稳定性并适应股骨头未来的生长。对于非常年幼的儿童（6 - 8岁），建议使用K针固定。骨科医生必须意识到使用K针时与内固定相关并发症的风险增加，可能需要手术处理。《希波克拉底》2019年，23(4): 165 - 168。
