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可伸缩螺钉在股骨头骨骺滑脱治疗中的优势:一项回顾性研究及文献综述

Advantages of Telescopic Screw in Slipped Capital Femoral Epiphysis Treatment: A Retrospective Study and Review of the Literature.

作者信息

Ulici Alexandru, Ionescu Adelina, Dogaru Diana, Hotoboc Olivia, Nahoi Catalin, Zamfir Cristian, Carp Madalina

机构信息

Pediatric Orthopedic Surgeon, Department of Pediatric Orthopedic Surgery, Emergency Hospital for Children "Grigore Alexandrescu", 011743 Bucharest, Romania.

11th Department, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania.

出版信息

Children (Basel). 2022 Mar 28;9(4):469. doi: 10.3390/children9040469.

Abstract

BACKGROUND

Slipped capital femoral epiphysis is due to proximal femur physis failure in adolescent patients. Early iatrogenic closure of proximal growth cartilage in children with significant residual growth potential causes complications such as coxa breva, coxa vara, and lower limb length inequalities. The Free-Gliding SCFE Screw System is a self-extending cannulated screw used in Slipped Capital Femoral Epiphysis (SCFE) fixation and femoral neck fractures.

MATERIALS AND METHOD

We conducted a retrospective study on 16 patients. All patients under 11 years old were treated by telescopic cannulated screws fixation. The youngest patient was 7 years old.

RESULTS

Out of the 22 operated hips, 2 screws have failed, thus resulting in a lack of telescoping of the screw. We discovered an average lengthening of approximately 10 mm at 24 months postoperative check-up in 20 hips in which lengthening took place. According to the Notzli method, none of the patients had an alpha angle value greater than 48 degrees.

CONCLUSION

Fixation with telescopic screw for SCFE in patients less than 11 years old, with mild to moderate slippage, allows the continuous growth and remodeling of the proximal femur, thus avoiding deformities such as coxa breva, coxa vara, FAI, AVN, limb length discrepancies and also allows good range of motion.

摘要

背景

股骨头骨骺滑脱是由于青少年患者股骨近端骨骺发育不良所致。对于仍有显著生长潜力的儿童,早期医源性闭合近端生长软骨会导致诸如髋内翻、髋外翻以及下肢长度不等的并发症。自由滑动式股骨头骨骺滑脱螺钉系统是一种用于股骨头骨骺滑脱(SCFE)固定和股骨颈骨折的自延长空心螺钉。

材料与方法

我们对16例患者进行了回顾性研究。所有11岁以下的患者均采用可伸缩空心螺钉固定治疗。最年轻的患者为7岁。

结果

在22例接受手术的髋关节中,有2枚螺钉失效,导致螺钉无法伸缩。在术后24个月的检查中,我们发现20例出现延长的髋关节平均延长了约10毫米。根据诺茨利方法,没有患者的α角值大于48度。

结论

对于11岁以下、轻度至中度滑脱的SCFE患者,使用可伸缩螺钉固定可使股骨近端持续生长和重塑,从而避免诸如髋内翻、髋外翻、股骨髋臼撞击症、股骨头缺血性坏死、肢体长度差异等畸形,并且还能实现良好的活动范围。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cfce/9026982/841ee83677dd/children-09-00469-g001.jpg

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