Carey R P, Moran P L, Cole W G
Department of Orthopaedics, Royal Children's Hospital, Parkville, Victoria, Australia.
Clin Orthop Relat Res. 1987 Nov(224):45-51.
Pin fixation in the treatment of slipped upper femoral epiphysis was evaluated in 60 patients admitted to the authors' hospital in Melbourne between 1970 and 1978. Forty-three cases were reviewed at an average of eight years following initial treatment. For chronic slips, in situ fixation with pins prevented further slip and promoted growth plate closure. The complication rate was low. Best results were achieved with two or three threaded pins placed into the posteroinferior segment of the femoral head to avoid avascular necrosis. Early upper femoral osteotomy was not required, as considerable bone remodeling occurred even after growth plate closure. In contrast, avascular necrosis was common following treatment of acute, severe slips, even with gentle internal rotation of the leg to reduce the acute component of the slip and pinning.
1970年至1978年间，墨尔本作者所在医院收治的60例股骨近端骨骺滑脱患者接受了钢针固定治疗。对其中43例患者在初始治疗后平均8年进行了复查。对于慢性滑脱，钢针原位固定可防止进一步滑脱并促进生长板闭合。并发症发生率较低。将两根或三根螺纹钢针置入股骨头后下部分可避免缺血性坏死，从而取得最佳效果。即使在生长板闭合后也会发生相当程度的骨重塑，因此无需早期进行股骨近端截骨术。相比之下，急性重度滑脱治疗后缺血性坏死很常见，即使轻柔地内旋下肢以减少滑脱的急性成分并进行钢针固定也是如此。
