PDF(Pubmed)
Abstract：
UNASSIGNED: The role of prophylactic pinning of the contralateral hip in unilateral SCFE is well established in patients with risk factors for developing contralateral slip. The effect of prophylactic pinning on the growth and morphology of the hip is not well documented in the literature. We aimed to study the effect of prophylactic pinning on the residual growth and morphology of the proximal femur.
UNASSIGNED: The institutional database was searched for all unilateral SCFE cases for the period 2011 to 2020. A total of 171 unilateral SCFE cases were identified. All the radiographs were scanned and those patients who had follow-up X-rays till skeletal maturity were included in the study. Prophylactic pinning was performed using 6.5 mm fully threaded cancellous screws in supine position on a radiolucent table. The following radiological parameters were measured on the post-operative X-rays and at skeletal maturity: (i) neck length (NL), (ii) neck-shaft angle (NSA), (iii) femoral offset (FO), (iv) articulo-trochanteric distance (ATD) and (iv) tip-apex distance (TAD) by two different observers.
UNASSIGNED: The mean age of the cohort was 13.7 years. ATD decreased from the mean value of 25.67 mm in post-operative radiographs to 20.84 mm in final follow-up radiographs. The NL, FO, and TAD were found to be increasing with age with mean final follow-up values of 55.35 mm, 41.41 mm, and 6.19 mm respectively compared to post-operative mean values of 50.95 mm, 37.4 mm, and 4.69 mm. There was no significant change in the neck-shaft angle. The mean post-operative NSA was 132.9° and it was 131.8° at final follow-up radiographs.
UNASSIGNED: Prophylactic pinning in unilateral SCFE does not stop the growth of the proximal femur completely. The ATD decreases in all the patients with prophylactic screw fixation probably due to the discrepancy in growth between the trochanteric apophysis and proximal femoral physis. The clinical effects of this subtle change in the morphology of the proximal femur need further investigation.
UNASSIGNED: Level IV Case series.
UNASSIGNED: The institutional database was searched for all unilateral SCFE cases for the period 2011 to 2020. A total of 171 unilateral SCFE cases were identified. All the radiographs were scanned and those patients who had follow-up X-rays till skeletal maturity were included in the study. Prophylactic pinning was performed using 6.5 mm fully threaded cancellous screws in supine position on a radiolucent table. The following radiological parameters were measured on the post-operative X-rays and at skeletal maturity: (i) neck length (NL), (ii) neck-shaft angle (NSA), (iii) femoral offset (FO), (iv) articulo-trochanteric distance (ATD) and (iv) tip-apex distance (TAD) by two different observers.
UNASSIGNED: The mean age of the cohort was 13.7 years. ATD decreased from the mean value of 25.67 mm in post-operative radiographs to 20.84 mm in final follow-up radiographs. The NL, FO, and TAD were found to be increasing with age with mean final follow-up values of 55.35 mm, 41.41 mm, and 6.19 mm respectively compared to post-operative mean values of 50.95 mm, 37.4 mm, and 4.69 mm. There was no significant change in the neck-shaft angle. The mean post-operative NSA was 132.9° and it was 131.8° at final follow-up radiographs.
UNASSIGNED: Prophylactic pinning in unilateral SCFE does not stop the growth of the proximal femur completely. The ATD decreases in all the patients with prophylactic screw fixation probably due to the discrepancy in growth between the trochanteric apophysis and proximal femoral physis. The clinical effects of this subtle change in the morphology of the proximal femur need further investigation.
UNASSIGNED: Level IV Case series.
摘要：
■在具有发生对侧滑脱的危险因素的患者中，对侧髋关节的预防性固定在单侧SCFE中的作用已得到证实。预防性钉扎对髋部生长和形态的影响在文献中没有很好的记载。我们旨在研究预防性钉扎对股骨近端残余生长和形态的影响。
■在机构数据库中搜索了2011年至2020年期间的所有单方面SCFE病例。共发现171例单侧SCFE病例。扫描所有X射线照片，并将进行X射线随访直至骨骼成熟的患者纳入研究。使用6.5mm全螺纹松质骨螺钉在射线可透过的桌子上仰卧位进行预防性固定。在术后X射线和骨骼成熟时测量以下放射学参数：（i）颈长（NL），（ii）颈轴角度（NSA），（iii）股骨偏移（FO），（iv）两个不同的观察者的关节-转子距离（ATD）和（iv）尖端-顶点距离（TAD）。
■该队列的平均年龄为13.7岁。ATD从术后X光片的平均值25.67mm降至最终随访X光片的20.84mm。NL,FO,发现TAD随着年龄的增长而增加，平均最终随访值为55.35mm，41.41毫米,和6.19mm，术后平均值分别为50.95mm，37.4mm,和4.69毫米。颈轴角无明显变化。术后平均NSA为132.9°，最终随访X线片为131.8°。
■单侧SCFE的预防性钉扎并不能完全阻止股骨近端的生长。所有预防性螺钉固定患者的ATD均降低，可能是由于转子骨和股骨近端之间的生长差异。股骨近端形态的这种细微变化的临床效果需要进一步研究。
■IV级案例系列。
■在机构数据库中搜索了2011年至2020年期间的所有单方面SCFE病例。共发现171例单侧SCFE病例。扫描所有X射线照片，并将进行X射线随访直至骨骼成熟的患者纳入研究。使用6.5mm全螺纹松质骨螺钉在射线可透过的桌子上仰卧位进行预防性固定。在术后X射线和骨骼成熟时测量以下放射学参数：（i）颈长（NL），（ii）颈轴角度（NSA），（iii）股骨偏移（FO），（iv）两个不同的观察者的关节-转子距离（ATD）和（iv）尖端-顶点距离（TAD）。
■该队列的平均年龄为13.7岁。ATD从术后X光片的平均值25.67mm降至最终随访X光片的20.84mm。NL,FO,发现TAD随着年龄的增长而增加，平均最终随访值为55.35mm，41.41毫米,和6.19mm，术后平均值分别为50.95mm，37.4mm,和4.69毫米。颈轴角无明显变化。术后平均NSA为132.9°，最终随访X线片为131.8°。
■单侧SCFE的预防性钉扎并不能完全阻止股骨近端的生长。所有预防性螺钉固定患者的ATD均降低，可能是由于转子骨和股骨近端之间的生长差异。股骨近端形态的这种细微变化的临床效果需要进一步研究。
■IV级案例系列。
