Busch M T, Morrissy R T
Scottish Rite Children's Hospital, Atlanta, Georgia.
Orthop Clin North Am. 1987 Oct;18(4):637-47.
SCFE is one of the most potentially damaging conditions of the adolescent hip. The onset may be associated with minor trauma but is often insidious and may present as vague thigh or knee pain. The lateral radiograph is the most sensitive view for detection of a low-grade slip. The contralateral hip must be examined carefully as there may be bilateral disease with the pain and disability of the presenting side masking the symptoms of less involved hip. SCFE is occasionally associated with other metabolic and endocrinologic disease, and these should be screened for in the history and physical examination. Once a slip begins, the hip remains at jeopardy for acute progression until the physeal plate closes. We recommend immediate surgical stabilization and prefer a cannulated screw system. Proper technique is critical to safe and reliable surgery. The most common complications, AVN and chondrolysis, are often related to technical errors and should be minimized with attention to detail.
股骨头骨骺滑脱是青少年髋关节最具潜在破坏性的病症之一。发病可能与轻微创伤有关，但通常隐匿，可能表现为大腿或膝盖隐痛。外侧位X线片是检测轻度滑脱最敏感的视图。必须仔细检查对侧髋关节，因为可能存在双侧病变，患侧的疼痛和残疾会掩盖受累较轻髋关节的症状。股骨头骨骺滑脱偶尔与其他代谢和内分泌疾病有关，应在病史和体格检查中进行筛查。一旦发生滑脱，在骨骺板闭合之前，髋关节仍有急性进展的风险。我们建议立即进行手术固定，首选空心螺钉系统。正确的技术对于安全可靠的手术至关重要。最常见的并发症，即股骨头缺血性坏死和关节软骨溶解，通常与技术失误有关，应通过注重细节将其降至最低。
