Shimizu Junya, Fujita Hiroki, Tateda Kenji, Kosukegawa Ima, Teramoto Atsushi
Department of Orthopedic Surgery, Sapporo Medical University, Sapporo, JPN.
Department of Orthopedic Surgery, Hokkaido Medical Center for Child Health and Rehabilitation, Sapporo, JPN.
Cureus. 2024 Feb 3;16(2):e53530. doi: 10.7759/cureus.53530. eCollection 2024 Feb.
Avascular necrosis, a serious slipped capital femoral epiphysis (SCFE) complication, is difficult to treat. We report a rare case of revascularization of the necrotic femoral head in a 12-year-old male patient with a severe SCFE (posterior tilting angle, 87°). We performed the modified Dunn procedure (MDP), followed by long-term unloading therapy. Blood flow to the epiphysis had partially resumed 2.3 years postoperatively. At the final 4.5-year follow-up, blood flow had been restored, leading to epiphyseal closure without significant femoral head deformity or hip pain. The patient could walk unassisted, with a flexion range of 120°. These findings support the use of the MDP with long-term unloading therapy as a potential treatment option for severe SCFE.
缺血性坏死是严重的股骨头骨骺滑脱（SCFE）并发症，难以治疗。我们报告了一例罕见的12岁男性严重SCFE（后倾角度87°）坏死股骨头再血管化病例。我们实施了改良邓恩手术（MDP），随后进行长期减负治疗。术后2.3年，骨骺的血流部分恢复。在最后4.5年的随访中，血流已恢复，导致骨骺闭合，股骨头无明显畸形或髋关节疼痛。患者无需辅助即可行走，屈曲范围为120°。这些发现支持将MDP联合长期减负治疗作为严重SCFE的一种潜在治疗选择。
