Kallio P E, Paterson D C, Foster B K, Lequesne G W
Adelaide Children's Hospital, Department of Orthopaedic Surgery, Australia.
Clin Orthop Relat Res. 1993 Sep(294):196-203.
In a prospective study of 26 hips in 21 patients with slipped capital femoral epiphyses (SCFEs), serial sonography was more sensitive than radiography in showing epiphyseal displacement and reduction. Reductions were associated with grossly visible hip joint effusions. The initial slips were reduced by treatment in seven of 11 hips with effusion. The 15 hips without effusion were unreduced. After stabilization and pinning, the effusion did not recur in any case. Sonography is sensitive and free from projectional errors in the assessment of metaphyseal remodeling. If any remodeling is present, the SCFE is at least three weeks in duration. A new classification into acute, acute-on-chronic, and chronic SCFEs is proposed, based on the objective sonographic data. Joint effusion represents physeal instability or recent progression, and remodeling is a sign of chronicity. An acute SCFE is characterized by effusion, whereas a slip without effusion but with remodeling is designated as chronic. An acute-on-chronic SCFE is associated with both effusion and remodeling. Joint effusion suggests that SCFEs should be operatively fixed and that displacement may diminish with traction or intraoperative positioning of the hip.
在一项对21例股骨头骨骺滑脱（SCFE）患者的26个髋关节进行的前瞻性研究中，系列超声检查在显示骨骺移位和复位方面比X线摄影更敏感。复位与明显可见的髋关节积液有关。在11个有积液的髋关节中，有7个通过治疗使最初的滑脱得到了复位。15个没有积液的髋关节未复位。在稳定和打钉后，积液在任何情况下都未复发。超声检查在评估干骺端重塑方面敏感且无投照误差。如果存在任何重塑，则SCFE病程至少为三周。基于客观的超声数据，提出了一种新的将SCFE分为急性、慢性急性发作和慢性的分类方法。关节积液代表骺板不稳定或近期进展，而重塑是慢性的标志。急性SCFE的特征是有积液，而无积液但有重塑的滑脱被指定为慢性。慢性急性发作的SCFE与积液和重塑都有关。关节积液提示SCFE应进行手术固定，并且移位可能会随着牵引或术中髋关节定位而减小。
