Salinas GGJ, Garza JF, Moreno GJA

Language: Spanish
References: 10
Page: 7-11
PDF size: 579.78 Kb.

ABSTRACT

Slipped Capital Femoral Epiphisys is the most common hip disorder in adolescents, is often associated with: a) conditions that dicrease the strength of the epiphisys (endocrine disorders), b) increase of the mechanical shear forces over the physis (obesity), and c) increase in the verticaly of physis, creating a retroversion deformity of the proximal femur.
We evaluated 20 patients, with 30 slipped capital femoral epiphysis that were treated with an in situ fixation using a single 6.5 cannulated screw under image-intensifier controlled vision. All of the patients had cronic slips with acute symptoms and were classified stable and unstable based on there ability to walk.
There was no increase of the slippage in the 18 (90%) of the patients with fussion of the physis 6 months after the surgery. The patients re-initiated painless walking 6 months after the surgery with better ranges of movements of the hips specially in flexion, abduction and internal rotation.
We conclude that the treatment of choice for stable chronic slipped cappital femoral epiphysis is in situ fixation with a single screw.

REFERENCES

1. Ward WT, Steko J, Wood KB, et al: Fixation with a single screw for slipped capital femoral epiphysis. J Bone Joint Surg 74 A:799-809, 1992.

2. Aronsson DD, Carlson WE, Slipped capital femoral epiphysis: A prospective study of fixation with a single screw. J Bone Joint Surg 74 A: 810-819.1992.

3. Morris RT: Slipped capital femoral epiphysis: Technique of percutaneus in situ fixation. J Pediatric Orthop 10:317-350, 1990.

4. Stanitsky CL: Acute slipped capital femoral epiphysts Treatment alternatives. J Am Acad Orthop Surg 2:96-106, 1996.

5. Boyer DW, Mickelson MR, Ponseti IV: Slipped capital femoral epiphysis: Long-therm follow up study of 121 patients. J Bone Joint Surg 63 A:85-95, 1981.

6. Clark HJ, Wilkinson JA: Surgical treatment for severe slipping of the upper femoral epiphysis: J Bone Joint Surg 72 B:854-858,1990.

7. Aronsson DD, Karol LA: Stable slipped capital femoral epiphysis: evaluation and management. J Am Acad A Orthop Surg 4:173-181,1996.

8. Crawford AH: Current concepts review: slipped capital femoral epiphysis. J Bone Joint Surg 70 A:1422-1427, 1988.

9. Loder RT, Richards BS, Shapiro PS, et al: Acute slipped femoral epiphysis: the importance of phiseal atability. J Bone Joint Surg 75 A:1134-1140, 1993.

10. Rley PM, Weiner DS, Gillespie R, Weiner SD: Hazzards of internal fixation in the treatment of slipped capital femoral epiphysis. J Bone Joint Surg 72 A:1500, 1990.