Jani L, Arnold P, Soloniewicz A
Orthopädische Klinik Mannheim, Universität Heidelberg.
Z Orthop Ihre Grenzgeb. 1996 Sep-Oct;134(5):400-6. doi: 10.1055/s-2008-1037427.
Slipped capital femoral epiphysis could be regarded as exceeding of a physiological process in puberty in which overweight of the patients seems to be the essential factor. Early clinical and radiological diagnosis are important to perform simple surgical procedures stopping further lysis and avoiding later osteoarthritis. Fixation of the femoral epiphysis with K.-wires are emphasized worldwide because of the lower complication rate. In case of severe slip osteotomies for realignment are more problematic. Long term follow-up studies have shown poor results mostly because of chondrolysis and femoral head necrosis in a high percentage. The demand on renunciation of realignment procedures in s.c.f.e. however, can't be supported. In our own patients, recently followed up, realignment osteotomies were without greater problems with no complications like chondrolysis or head necrosis. Stabile fixation of osteotomies allowed early mobilisation just after operation and may be one reason that chondrolysis didn't exist in our patient group. Considering our knowledge today therapeutic procedure of slipped capital femoral epiphysis is described.
股骨头骨骺滑脱可被视为青春期生理过程的过度表现，其中患者超重似乎是关键因素。早期临床和放射学诊断对于实施简单的外科手术以阻止进一步溶解并避免后期骨关节炎至关重要。由于并发症发生率较低，全世界都强调用克氏针固定股骨骨骺。在严重滑脱的情况下，用于重新对齐的截骨术则更具问题。长期随访研究显示结果不佳，主要原因是软骨溶解和股骨头坏死的发生率很高。然而，放弃在股骨头骨骺滑脱中进行重新对齐手术的要求是无法得到支持的。在我们自己最近随访的患者中，重新对齐截骨术没有太大问题，没有出现软骨溶解或股骨头坏死等并发症。截骨术的稳定固定允许术后早期活动，这可能是我们患者组中不存在软骨溶解的原因之一。基于我们目前的认知，描述了股骨头骨骺滑脱的治疗方法。
