Department of Children's Orthopedics, Clínica del Campestre, Hospital Infantil Santa Ana, Fundación Clínica Noel, CORA Group, Medellín, Colombia.
Department of Orthopedics and Traumatology, Clínica del Campestre, Medellín, Colombia.
Clin Orthop Surg. 2021 Sep;13(3):415-422. doi: 10.4055/cios19038. Epub 2021 May 4.
Slipped capital femoral epiphysis (SCFE) is a severe and catastrophic disorder that affects the hips of adolescents. Many reports about surgical procedures to treat this condition have been published, but to our knowledge, there are no published results of treatment in Latin American patients. This study describes the clinical and radiological results of the modified Dunn procedure with the surgical approach described by Ganz to treat mild to severe SCFE in a cohort of Colombian pediatric patients.
We retrospectively analyzed 21 patients (22 hips) with SCFE treated with surgical dislocation of the hip from 2005 to 2017. The same pediatric orthopedic surgeon performed all operations. Clinical outcome was assessed using the range of movement and Merle d'Aubigné score, while radiological measurements and assessment included the slip angle and Tönnis score.
The average duration of follow-up was 29 months (range, 12-72 months). Of all cases, 17 presented with acute-on-chronic symptoms. Preoperatively, all 22 hips were classified as poor according to the Merle d'Aubigné score. Preoperative radiological classification showed compromise grade II or III in 20 hips. Last follow-up Merle d'Aubigné score rated 17 cases as good or excellent ( < 0.05). The postoperative radiological classification was grade I or II in all 22 cases, and the Tönnis score was stage II in 3 cases and stage III in 4 cases.
Our results suggest that the modified Dunn osteotomy performed through the Ganz technique could be safely and effectively used to treat patients with mild to severe SCFE.
股骨颈前滑脱(SCFE)是一种严重且灾难性的疾病,影响青少年的髋关节。已经有许多关于治疗这种疾病的手术方法的报告,但据我们所知,在拉丁美洲患者中没有治疗结果的报告。本研究描述了改良的 Dunn 手术与 Ganz 描述的手术入路治疗轻度至重度 SCFE 的临床和影像学结果,该手术入路治疗了一组哥伦比亚儿科患者。
我们回顾性分析了 2005 年至 2017 年间接受髋关节脱位手术治疗的 21 例(22 髋)SCFE 患者。所有手术均由同一位小儿矫形外科医生完成。临床结果通过活动范围和 Merle d'Aubigné 评分进行评估,而影像学测量和评估包括滑脱角和 Tönnis 评分。
平均随访时间为 29 个月(范围 12-72 个月)。所有病例中,17 例为急性慢性症状。术前所有 22 髋根据 Merle d'Aubigné 评分均为较差。术前影像学分类显示 20 髋为 II 级或 III 级。末次随访时 Merle d'Aubigné 评分 17 例为良好或优秀(<0.05)。所有 22 例术后影像学分类为 I 级或 II 级,Tönnis 评分 3 例为 II 期,4 例为 III 期。
我们的结果表明,通过 Ganz 技术进行的改良 Dunn 截骨术可安全有效地用于治疗轻度至重度 SCFE 患者。