From the Department of Orthopaedic Surgery, BC Children's Hospital, Vancouver, BC, Canada (Jin, Habib, Dr. Schaeffer, and Dr. Mulpuri); the Children's Hospital Queensland, South Brisbane, Australia (Farrell); the Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, BC (Dr. Schaeffer, and Dr. Mulpuri); and the BC Children's Research Institute, University of British Columbia, Vancouver BC (Sandhu, and Bone).
J Am Acad Orthop Surg Glob Res Rev. 2022 Jul 6;6(7). doi: 10.5435/JAAOSGlobal-D-21-00135. eCollection 2022 Jul 1.
Slipped capital femoral epiphysis is commonly treated with in situ pinning (ISP) and more recently the modified Dunn procedure (MDP). This study retrospectively examines the preoperative risk factors and postoperative complications of patients treated with either ISP or MDP over a 12-year period.
A single-center, retrospective review was conducted on patients diagnosed and surgically treated with slipped capital femoral epiphysis from 2004 to 2016. Patients must have had preoperative imaging and a minimum of 6 months of clinical follow-up. Six preoperative demographic data (age, sex, intensity of symptoms, stability, trauma, and severity of slip), surgical details, and treatment outcomes were collected. Descriptive statistics were used to identify pertinent preoperative risk factors and postoperative complications in each treatment group.
A total of 129 hips in 98 patients were treated (118 with ISP and 11 with MDP). Complications developed in 12 hips. Six hips developed osteonecrosis, two hips developed osteonecrosis and chondrolysis, two hips developed osteonecrosis and slip progression, and two hips developed slip progression only. Four of the 11 hips (36.4%) treated with MDP developed complications; 8 of the 118 hips (6.8%) treated with ISP developed complications.
Complications developed in 9.3% of hips treated with ISP or MDP, with a higher rate of complications observed in the MDP group compared with the ISP group. This study is limited by the small sample size of the cohort and the disproportion in the number of cases in each treatment group. A multicenter study with larger sample sizes will be required to confirm these findings.
股骨颈骨骺滑脱通常采用原位钉钉（ISP）治疗，最近采用改良邓恩手术（MDP）治疗。本研究回顾性分析了 12 年来采用 ISP 或 MDP 治疗的患者的术前危险因素和术后并发症。
对 2004 年至 2016 年诊断并接受股骨颈骨骺滑脱手术治疗的患者进行了单中心回顾性研究。患者必须有术前影像学检查和至少 6 个月的临床随访。收集了术前 6 项人口统计学数据（年龄、性别、症状强度、稳定性、外伤和滑脱严重程度）、手术细节和治疗结果。采用描述性统计方法确定每组治疗的相关术前危险因素和术后并发症。
共治疗了 98 例患者的 129 髋（118 例采用 ISP，11 例采用 MDP）。12 髋出现并发症。6 髋发生骨坏死，2 髋发生骨坏死伴软骨溶解，2 髋发生骨坏死伴滑脱进展，2 髋仅发生滑脱进展。MDP 治疗的 11 髋中有 4 髋（36.4%）发生并发症；ISP 治疗的 118 髋中有 8 髋（6.8%）发生并发症。
采用 ISP 或 MDP 治疗的髋部并发症发生率为 9.3%，MDP 组的并发症发生率高于 ISP 组。本研究受到队列中样本量小以及每组病例数量不均的限制。需要进行更大样本量的多中心研究来证实这些发现。
