Abstract：
BACKGROUND: Slipped capital femoral epiphysis (SCFE) requires surgical treatment when diagnosed. The surgical management of moderate to severe SCFE remains an area of controversy among pediatric orthopedic surgeons. The severity of slippage, the viability of the femoral epiphysis, and the method of surgical management determine the long-term clinical and radiographical outcome. This study sought to evaluate the mid-term results of subcapital realignment of chronic stable slipped femoral epiphysis with open physis using surgical hip dislocation.
METHODS: This study was a prospective case series of adolescents with moderate or severe degrees of chronic SCFE who had undergone subcapital osteotomy using the surgical hip dislocation technique. The Harris Hip Score (HHS) was used to assess functional outcomes at 6 years of follow-up. A HHS of ≥ 80 points was considered satisfactory. Postoperative radiological outcomes were evaluated using epiphyseal-shaft angles and alpha angles. Postoperative complications were observed.
RESULTS: This study included 40 patients, 32 (80%) males and 8 (20%) females, with a mean age of 14.1 ± 1.8 years. There was a statistically significant improvement in the mean HHS from 45 ± 12.3 preoperatively to 91.8 ± 11.6 points at 6 years of follow-up. The mean epiphyseal-shaft angle reduced from 60.5 ± 15.3° preoperatively to 10.3 ± 2.4° postoperatively, P < 0.001. The mean alpha angle reduced from 72.5 ± 10.1° preoperatively to 40.4 ± 6.4°, P < 0.001. Four (10%) patients showed femoral head avascular necrosis (AVN).
CONCLUSIONS: Subcapital realignment of chronic SCFE can achieve satisfactory clinical and radiological outcomes, but femoral head AVN remains a risk. Level of evidence Level IV.
METHODS: This study was a prospective case series of adolescents with moderate or severe degrees of chronic SCFE who had undergone subcapital osteotomy using the surgical hip dislocation technique. The Harris Hip Score (HHS) was used to assess functional outcomes at 6 years of follow-up. A HHS of ≥ 80 points was considered satisfactory. Postoperative radiological outcomes were evaluated using epiphyseal-shaft angles and alpha angles. Postoperative complications were observed.
RESULTS: This study included 40 patients, 32 (80%) males and 8 (20%) females, with a mean age of 14.1 ± 1.8 years. There was a statistically significant improvement in the mean HHS from 45 ± 12.3 preoperatively to 91.8 ± 11.6 points at 6 years of follow-up. The mean epiphyseal-shaft angle reduced from 60.5 ± 15.3° preoperatively to 10.3 ± 2.4° postoperatively, P < 0.001. The mean alpha angle reduced from 72.5 ± 10.1° preoperatively to 40.4 ± 6.4°, P < 0.001. Four (10%) patients showed femoral head avascular necrosis (AVN).
CONCLUSIONS: Subcapital realignment of chronic SCFE can achieve satisfactory clinical and radiological outcomes, but femoral head AVN remains a risk. Level of evidence Level IV.
摘要：
背景：在诊断时，股骨干骨粘连（SCFE）滑脱需要手术治疗。中度至重度SCFE的手术管理仍然是儿科骨科医师争议的领域。打滑的严重程度，股骨骨的活力，外科治疗方法决定了长期的临床和影像学结果。这项研究旨在评估使用手术髋关节脱位对慢性稳定性股骨骨epi滑脱伴开放性骨physis的资本下重新排列的中期结果。
方法：本研究是对患有中度或重度慢性SCFE的青少年进行的前瞻性病例系列，这些青少年使用外科髋关节脱位技术进行了大骨下截骨术。Harris髋关节评分（HHS）用于评估随访6年的功能结果。≥80分的HHS被认为是令人满意的。使用骨-轴角和α角评估术后放射学结果。观察术后并发症发生情况。
结果：本研究包括40名患者，32（80％）男性和8（20％）女性，平均年龄为14.1±1.8岁。在6年的随访中，平均HHS从术前的45±12.3分提高到91.8±11.6分。平均骨phy轴角度从术前60.5±15.3°减小至术后10.3±2.4°，P<0.001。平均α角从术前的72.5±10.1°减小到40.4±6.4°,P<0.001。4例（10％）患者出现股骨头缺血性坏死（AVN）。
结论：慢性SCFE的亚资本重组可获得满意的临床和放射学结果，但股骨头AVN仍然存在风险。证据级别IV级。
方法：本研究是对患有中度或重度慢性SCFE的青少年进行的前瞻性病例系列，这些青少年使用外科髋关节脱位技术进行了大骨下截骨术。Harris髋关节评分（HHS）用于评估随访6年的功能结果。≥80分的HHS被认为是令人满意的。使用骨-轴角和α角评估术后放射学结果。观察术后并发症发生情况。
结果：本研究包括40名患者，32（80％）男性和8（20％）女性，平均年龄为14.1±1.8岁。在6年的随访中，平均HHS从术前的45±12.3分提高到91.8±11.6分。平均骨phy轴角度从术前60.5±15.3°减小至术后10.3±2.4°，P<0.001。平均α角从术前的72.5±10.1°减小到40.4±6.4°,P<0.001。4例（10％）患者出现股骨头缺血性坏死（AVN）。
结论：慢性SCFE的亚资本重组可获得满意的临床和放射学结果，但股骨头AVN仍然存在风险。证据级别IV级。
