Grade Dorothea, Tabelião Kim, Horn Anria
Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
Groote Schuur Hospital, Cape Town, South Africa.
Int Orthop. 2025 Jul 14. doi: 10.1007/s00264-025-06611-3.
There is growing evidence that after moderate and severe slipped capital femoral epiphysis (SCFE), in-situ fixation can result in femoroacetabular impingement (FAI). Several different realignment procedures have been described but their use remains controversial due to high complication rates and technical complexity. Our study aims to evaluate the radiological outcomes and complications of patients who underwent open reduction with subcapital shortening osteotomy for moderate or severe SCFE.
Radiographic and clinical data of patients with SCFE treated with subcapital shortening osteotomy performed by a single surgeon between October 2018 and July 2023 were retrospectively analysed. We collected patient demographics, pre- and post-operative radiographic measurements (Southwick slip angle, alpha angle and articulo-trochanteric distance (ADT), and post-operative complications. Patient outcomes were assessed using descriptive statistics.
Eighteen children and adolescents were reviewed, four were excluded due to inadequate follow-up. At the last follow-up, the lateral Southwick slip angle was corrected to a mean of 11 ° (1-31°). The mean alpha angle, measured at the final follow-up, was 59 ° (42-88°). One patient showed signs of radiological coxa breva. There were two patients with severe radiological cam deformities and one case of avascular necrosis (AVN).
Our findings suggest that the subcapital shortening osteotomy is an effective method for restoring head-neck anatomy in patients with moderate to severe SCFE, with good radiological outcomes. Our low incidence of avascular necrosis further supports the safety of this procedure.
越来越多的证据表明，在中度和重度股骨头骨骺滑脱（SCFE）后，原位固定可导致股骨髋臼撞击（FAI）。已经描述了几种不同的重新对齐手术，但由于高并发症发生率和技术复杂性，其使用仍存在争议。我们的研究旨在评估接受开放复位并进行股骨头下缩短截骨术治疗中度或重度SCFE患者的放射学结果和并发症。
回顾性分析2018年10月至2023年7月期间由单一外科医生进行股骨头下缩短截骨术治疗的SCFE患者的影像学和临床数据。我们收集了患者的人口统计学资料、术前和术后的影像学测量数据（Southwick滑脱角、α角和关节转子间距离（ADT））以及术后并发症。使用描述性统计评估患者的结果。
对18名儿童和青少年进行了评估，4名因随访不足而被排除。在最后一次随访时，外侧Southwick滑脱角平均校正至11°（1-31°）。在最后一次随访时测量的平均α角为59°（42-88°）。1例患者出现放射学上的髋内翻迹象。有2例患者出现严重的放射学凸轮畸形，1例出现缺血性坏死（AVN）。
我们的研究结果表明，股骨头下缩短截骨术是恢复中度至重度SCFE患者头颈解剖结构的有效方法，放射学结果良好。我们低的缺血性坏死发生率进一步支持了该手术的安全性。
