PDF(Pubmed)
Abstract：
BACKGROUND: In Sweden, most children with slipped capital femoral epiphysis (SCFE) are operated on with a single smooth pin or a short-threaded screw, allowing further growth of the femoral neck. Using the Swedish Pediatric Orthopaedic Quality registry, SPOQ, we investigated whether angular remodelling occurs adjacent to the proximal femoral epiphysis after fixation of SCFE using implants, allowing continued growth of the femoral neck.
METHODS: During 2008-2010 a total national population of 155 children were reported to the SPOQ registry. Following our strict inclusion criteria, radiographs of 51 hips were further assessed. The lateral Head Shaft Angle (HSA), the Nötzli 3-point α-angle, the anatomic α-angle, and the Anterior Offset Ratio (AOR) on the first postoperative radiographs and at follow-up were measured to describe the occurrence of remodelling. Slip severity was categorised as mild, moderate or severe according to postoperative HSA.
RESULTS: Mean and SD values for the change in HSA were 3,7° (5,0°), for 3-point α-angle 6,8° (8,9°), and anatomic α-angle 13,0° (16,3°). The overall increase in AOR was 0,038 (0.069). There were no significant differences between the slip severity groups.
CONCLUSIONS: We found limited angular remodelling after in situ fixation with smooth pins or short threaded screws for SCFE. The angular remodelling and the reduction of the CAM deformity was less than previously described after fixation of SCFE with similar implants. Results about the same magnitude with non-growth sparing techniques suggest that factors other than longitudinal growth of the femoral neck are important for angular remodelling.
METHODS: During 2008-2010 a total national population of 155 children were reported to the SPOQ registry. Following our strict inclusion criteria, radiographs of 51 hips were further assessed. The lateral Head Shaft Angle (HSA), the Nötzli 3-point α-angle, the anatomic α-angle, and the Anterior Offset Ratio (AOR) on the first postoperative radiographs and at follow-up were measured to describe the occurrence of remodelling. Slip severity was categorised as mild, moderate or severe according to postoperative HSA.
RESULTS: Mean and SD values for the change in HSA were 3,7° (5,0°), for 3-point α-angle 6,8° (8,9°), and anatomic α-angle 13,0° (16,3°). The overall increase in AOR was 0,038 (0.069). There were no significant differences between the slip severity groups.
CONCLUSIONS: We found limited angular remodelling after in situ fixation with smooth pins or short threaded screws for SCFE. The angular remodelling and the reduction of the CAM deformity was less than previously described after fixation of SCFE with similar implants. Results about the same magnitude with non-growth sparing techniques suggest that factors other than longitudinal growth of the femoral neck are important for angular remodelling.
摘要：
背景：在瑞典，大多数患有滑脱股骨骨phy（SCFE）的儿童使用单个光滑的销钉或短螺纹螺钉进行手术，允许股骨颈进一步生长。使用瑞典儿科骨科质量注册表，SPOQ,我们研究了使用植入物固定SCFE后，是否在股骨近端骨epi附近发生角度重塑，允许股骨颈的持续增长。
方法：在2008-2010年期间，向SPOQ登记处报告的全国共有155名儿童。按照我们严格的纳入标准，进一步评估了51髋的X光片。侧头轴角度(HSA),Nötzli三点α角，解剖α角,测量术后第一次X光片和随访时的前偏移比（AOR）以描述重塑的发生。打滑严重程度被归类为轻度，中度或重度根据术后HSA。
结果：HSA变化的平均值和SD值为3,7°（5,0°），对于3点α角6,8°（8,9°），和解剖α角13,0°(16,3°)。AOR的总体增加为0.038(0.069)。滑脱严重程度组之间没有显着差异。
结论：我们发现SCFE用光滑销钉或短螺纹螺钉原位固定后的角度重塑有限。在用类似的植入物固定SCFE后，CAM畸形的角度重塑和减少少于先前描述的。使用非生长保留技术的相同幅度的结果表明，除股骨颈的纵向生长外，其他因素对于角度重塑也很重要。
方法：在2008-2010年期间，向SPOQ登记处报告的全国共有155名儿童。按照我们严格的纳入标准，进一步评估了51髋的X光片。侧头轴角度(HSA),Nötzli三点α角，解剖α角,测量术后第一次X光片和随访时的前偏移比（AOR）以描述重塑的发生。打滑严重程度被归类为轻度，中度或重度根据术后HSA。
结果：HSA变化的平均值和SD值为3,7°（5,0°），对于3点α角6,8°（8,9°），和解剖α角13,0°(16,3°)。AOR的总体增加为0.038(0.069)。滑脱严重程度组之间没有显着差异。
结论：我们发现SCFE用光滑销钉或短螺纹螺钉原位固定后的角度重塑有限。在用类似的植入物固定SCFE后，CAM畸形的角度重塑和减少少于先前描述的。使用非生长保留技术的相同幅度的结果表明，除股骨颈的纵向生长外，其他因素对于角度重塑也很重要。
