Kulick R G, Denton J R
Clin Orthop Relat Res. 1982 Jan-Feb(162):87-90.
A series of 125 cases of slipped capital femoral epiphysis in 94 patients was followed an average of 4.7 years. Initial treatment consisted of closed reduction with internal fixation in 13 cases, cervical cuneiform osteotomy with internal fixation in nine, and in situ fixation in the remainder. The end-results were good in 82% of the cases. Of the nine failures, eight were due to avascular necrosis or chondrolysis. Closed reduction should be performed only in acute or acute-on-chronic slippings. Chronic slippings should be nailed in situ. The use of more involved procedures, such as cuneiform osteotomy, is not recommended because of the risk of avascular necrosis and because they do not allow the natural forces of remodeling to improve the deformity. Using this method, only three slippings required subsequent osteotomy.
对94例共125例股骨头骨骺滑脱病例进行了平均4.7年的随访。初始治疗包括13例行闭合复位内固定，9例行颈椎楔形截骨内固定，其余行原位固定。82%的病例最终结果良好。9例失败病例中，8例是由于缺血性坏死或软骨溶解。闭合复位仅应在急性或急性-慢性滑脱时进行。慢性滑脱应原位穿钉。不建议使用更复杂的手术，如楔形截骨，因为有缺血性坏死的风险，且它们不允许重塑的自然力量改善畸形。采用这种方法，只有3例滑脱需要后续截骨。
