Gelberman R H, Cohen M S, Shaw B A, Kasser J R, Griffin P P, Wilkinson R H
J Bone Joint Surg Am. 1986 Sep;68(7):1000-7.
We examined twenty-five patients who had a unilateral or bilateral slip of the capital femoral epiphysis and determined the degree of anteversion of the thirty-nine involved hips with computerized axial tomography. Thirteen patients (eighteen hips) were seen at the time of the original diagnosis (Group I), and twelve patients (twenty-one hips) were seen one to seven years after operative treatment (Group II). The mean amount of anteversion for all of the involved hips was +1.0 +/- 8.2 degrees. The mean amount of anteversion for the Group-I hips was -0.7 +/- 7.4 degrees and the mean amount for the Group-II hips was 2.5 +/- 8.7 degrees. The mean amount of anteversion for the hips in both Groups I and II was less than the predicted mean amount for individuals of the same age. The mean amount of anteversion of the unaffected hips of our patients who had a unilateral slip was +6.3 +/- 8.2 degrees. The amount of internal rotation of the hip in extension exceeded the amount when it was in flexion in all of the patients. A decreased angle of femoral anteversion appears to be specifically associated with the development of slipped capital femoral epiphysis. The mechanical forces that act across the proximal femoral physis may be altered by this rotational abnormality, and this may lead to an increased shear stress that ultimately causes failure of the growth plate.
我们检查了25例患有单侧或双侧股骨头骨骺滑脱的患者，并通过计算机断层扫描确定了39个受累髋关节的前倾角度。13例患者（18个髋关节）在初次诊断时就诊（I组），12例患者（21个髋关节）在手术治疗后1至7年就诊（II组）。所有受累髋关节的平均前倾角度为+1.0±8.2度。I组髋关节的平均前倾角度为-0.7±7.4度，II组髋关节的平均前倾角度为2.5±8.7度。I组和II组髋关节的平均前倾角度均低于同年龄个体的预测平均值。单侧滑脱患者未受累髋关节的平均前倾角度为+6.3±8.2度。所有患者髋关节伸展时的内旋角度均超过屈曲时的角度。股骨前倾角度减小似乎与股骨头骨骺滑脱的发生密切相关。这种旋转异常可能会改变作用于股骨近端骨骺的机械力，进而导致剪切应力增加，最终导致生长板失效。
