Titre :

Evolution of slipped capital femoral epiphysis after in situ screw fixation at a mean 11 years' follow-up: a 222 case series

Auteur(s) :

Nectoux, Eric [Auteur]
Decaudain, J. [Auteur]
Accadbled, F. [Auteur]
Hamel, A. [Auteur]
Bonin, N. [Auteur]
Gicquel, P. [Auteur]

Titre de la revue :

Orthopaedics & traumatology, surgery & research . OTSR

Nom court de la revue :

Orthop. Traumatol.-Surg. Res.

Numéro :

101

Pagination :

51-54

Date de publication :

2015-02-01

ISSN :

1877-0568

Mot(s)-clé(s) en anglais :

Slipped capital femoral epiphysis
In situ screw fixation
Femoroacetabular impingement

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BACKGROUND: Slipped capital femoral epiphysis (SCFE) can lead to hip impingement, more or less rapidly depending on initial slippage severity and on surgical technique. Various surgical options are applicable, including ...
Lire la suite >BACKGROUND: Slipped capital femoral epiphysis (SCFE) can lead to hip impingement, more or less rapidly depending on initial slippage severity and on surgical technique. Various surgical options are applicable, including in situ fixation (ISF). The aim of the present study was to look for long-term signs of radiological impingement in hips treated for SCFE by IFS, in order to identify a slip threshold beyond which impingement more regularly appears. METHODS: A multicenter retrospective study assessed the clinical and radiological evolution of patients operated on by ISF for SCFE, with a minimum 10 year's follow-up. Coxometric analysis of postoperative and last follow-up radiographs was performed. Functional outcome was assessed on Oxford hip score and radiographic osteoarthritis on the Tönnis classification. Alpha angle was measured on lateral views to highlight hip impingement. RESULTS: Two hundred and twenty-two hips were included, with a mean 11.2 years' follow-up. Mean age at diagnosis was 12.8 years. Mean preoperative Southwick angle was 38.8°, with 43% of hips at stage I, 42% at stage II and 15% at stage III. At latest follow-up, mean Oxford score was 14.86, with 88% of hips rated Tönnis 0 or I. Only 15 cases of impingement were diagnosed. There seemed to be a non-significant trend for hip impingement in SCFE exceeding 35°. CONCLUSIONS: ISF led to hip impingement in moderate to severe initial epiphyseal displacement. However, in smaller displacement, the consequences were milder, with perfectly satisfactory function scores and no clinical or radiological evidence of impingement. The threshold seemed to be around 35° slippage, beyond which other surgical options than ISF should be considered. Thus, it seems reasonable to propose isolated ISF in SCFE<35° and to treat symptomatic impingement by surgery in stage II slips.Lire moins >

Langue :

Anglais

Audience :

Internationale

Vulgarisation :

Non

Établissement(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Date de dépôt :

2019-12-09T18:15:12Z