E Schumann1, D Zajonz2, M Wojan2, F B Kübler2, P Brandmaier3, C Josten2, C-E Heyde2, U Bühligen4. 1. Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland. Eckehard.schumann@uniklinik-leipzig.de. 2. Klinik und Poliklinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Universitätsklinikum Leipzig, 04103, Leipzig, Deutschland. 3. Klinik und Poliklinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum Leipzig, Leipzig, Deutschland. 4. Klinik und Poliklinik für Kinderchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Abstract
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is a multifactorial structural loosening in the area through the epiphyseal plate between the epiphysis and metaphysis accompanied by slippage of the femoral head in the mid-dorsal-caudal direction without additional adequate trauma. In this retrospective study, all patients with chronic SCFE were assessed who had been treated by implanting a dynamic epiphyseal telescopic (DET) screw. METHODOLOGY: All patients who had been treated at our hospital with a DET screw implant between December 2006 and November 2014 following diagnosis of chronic SCFE were included in the study. Clinical and radiological follow-up was carried out after 6 weeks, 12 weeks, and then every 6 months. RESULTS: In all patients, the SCFE proved to have been firmly fixed and no further slippage was observed in any patient on the side affected. None of the prophylactically treated hips showed secondary SCFE either. In all patients, the DET screw led to partial remodeling of the slippage. The average slippage angle according to Southwick (epsilon angle) was about 30° preoperatively and about 19° in the most recent radiological follow-up. The alpha angle according to Nötzli was about 91° preoperatively and about 62° in the most recent radiological follow-up. Most of the patients showed none treatment-related dysfunction. CONCLUSION: Surgical treatment with a DET screw seems to be a safe procedure for both the affected hip and the hip to be treated prophylactically. This method is an adequate alternative to the widespread technique of pinning with K‑wires.
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is a multifactorial structural loosening in the area through the epiphyseal plate between the epiphysis and metaphysis accompanied by slippage of the femoral head in the mid-dorsal-caudal direction without additional adequate trauma. In this retrospective study, all patients with chronic SCFE were assessed who had been treated by implanting a dynamic epiphyseal telescopic (DET) screw. METHODOLOGY: All patients who had been treated at our hospital with a DET screw implant between December 2006 and November 2014 following diagnosis of chronic SCFE were included in the study. Clinical and radiological follow-up was carried out after 6 weeks, 12 weeks, and then every 6 months. RESULTS: In all patients, the SCFE proved to have been firmly fixed and no further slippage was observed in any patient on the side affected. None of the prophylactically treated hips showed secondary SCFE either. In all patients, the DET screw led to partial remodeling of the slippage. The average slippage angle according to Southwick (epsilon angle) was about 30° preoperatively and about 19° in the most recent radiological follow-up. The alpha angle according to Nötzli was about 91° preoperatively and about 62° in the most recent radiological follow-up. Most of the patients showed none treatment-related dysfunction. CONCLUSION: Surgical treatment with a DET screw seems to be a safe procedure for both the affected hip and the hip to be treated prophylactically. This method is an adequate alternative to the widespread technique of pinning with K‑wires.
Authors: Perry L Schoenecker; J Eric Gordon; Scott J Luhmann; Matthew B Dobbs; Kathryn A Keeler; John C Clohisy Journal: J Pediatr Orthop Date: 2013 Jul-Aug Impact factor: 2.324