In situ fixation of slipped capital femoral epiphysis with Steinmann pins. 2011

Trude G Lehmann, and Ingvild Ø Engesæter, and Lene B Laborie, and Karen Rosendahl, and Stein Atle Lie, and Lars B Engesæter
Department of Orthopaedic Surgery, Haukeland University Hospital, Norway. trude.gundersen.lehmann@helse-bergen.no

OBJECTIVE Slipped capital femoral epiphysis (SCFE) is often treated by surgical fixation; however, no agreement exists regarding technique. We analyzed the outcome of in situ fixation with Steinmann pins. METHODS All 67 subjects operated for slipped capital femoral epiphysis at Haukeland University Hospital during the period 1990-2007 were included. All were treated by in situ fixation with 2 or 3 parallel Steinmann pins (8 mm threads at the medial end). The follow-up evaluation consisted of clinical examination and hip radiographs. Radiographic outcome was based on measurements of slip progression, growth of the femoral neck, leg length discrepancy, and signs of avascular necrosis and chondrolysis. RESULTS 67 subjects (41 males) were operated due to unilateral slips (n = 47) or bilateral slips (n = 20). Mean age at time of diagnosis was 13 (7.2-16) years. Mean age at follow-up was 19 (14-30) years, with a mean postoperative interval of 6.0 (2-16) years. The operated femoral neck was 9% longer at skeletal maturity than at surgery, indicating continued growth of the femoral neck. At skeletal maturity, 12 subjects had radiographic features suggestive of a previous asymptomatic slip of the contralateral hip. The total number of bilateral cases of SCFE was 32, i.e half of the children had bilateral SCFE. 3 subjects required additional surgery and mild avascular necrosis of the femoral head was seen in 1 patient. None had slip progression or chondrolysis. CONCLUSIONS In situ pinning of SCFE with partly threaded Steinmann pins appears to be a feasible and safe method, with few complications. The technique allows further growth of the femoral neck.

UI MeSH Term Description Entries
D008297 Male Males
D010027 Osteotomy The surgical cutting of a bone. (Dorland, 28th ed) Osteotomies
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D001858 Bone Nails Rods of bone, metal, or other material used for fixation of the fragments or ends of fractured bones. Bone Pins,Bone Nail,Bone Pin,Nail, Bone,Nails, Bone,Pin, Bone,Pins, Bone
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004839 Epiphyses, Slipped A complete or partial separation of the EPIPHYSES from the DIAPHYSES. Epiphysiolysis,Epiphysiolyses,Slipped Epiphyses
D005260 Female Females
D005270 Femur Head The hemispheric articular surface at the upper extremity of the thigh bone. (Stedman, 26th ed) Femoral Head,Femoral Heads,Femur Heads,Head, Femoral,Head, Femur
D005271 Femur Head Necrosis Aseptic or avascular necrosis of the femoral head. The major types are idiopathic (primary), as a complication of fractures or dislocations, and LEGG-CALVE-PERTHES DISEASE. Aseptic Necrosis of Femur Head,Avascular Necrosis of Femur Head,Necrosis, Aseptic, of Femur Head,Necrosis, Avascular, of Femur Head,Avascular Necrosis Of Femoral Head, Primary,Femoral Head, Avascular Necrosis Of,Ischemic Necrosis Of Femoral Head,Femur Head Necroses,Head Necrosis, Femur,Necrosis, Femur Head
D005500 Follow-Up Studies Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease. Followup Studies,Follow Up Studies,Follow-Up Study,Followup Study,Studies, Follow-Up,Studies, Followup,Study, Follow-Up,Study, Followup

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