PDF(Pubmed)
Abstract：
While the usual etiology of slipped capital femoral epiphysis (SCFE) is idiopathic, there are many other factors that increase the predisposition to slippage. Chemotherapy can be one of them. In this article, we report a rare case of acute SCFE after tumor prosthesis implantation in a patient who received chemotherapy. A 10-year-old girl with osteosarcoma of the right distal femur underwent (neo-) adjuvant chemotherapy, wide tumor resection, and reconstruction using a growing tumor prosthesis and a short non-cemented femoral stem. Half a year after implantation, she developed aseptic loosening. Revision surgery was performed using a hydroxyapatite (HA)-coated cementless femoral stem. Postoperative plain radiographs revealed SCFE that was treated by closed reduction and screw fixation. The patient recovered without complications, and unaffected hip showed no radiographic signs of slippage on follow-up. The forces of implanting a tumor prosthesis, particularly with a non-cemented stem, can increase the risk of an acute SCFE. The controversy over prophylactic pinning of the uninvolved hip in chemotherapy-associated SCFE is unresolved. Pinning can be considered only in the presence of abnormal prodromal radiological findings.
摘要：
虽然滑脱的股骨骨phy（SCFE）的通常病因是特发性的，还有许多其他因素会增加打滑的倾向。化疗可能是其中之一。在这篇文章中,我们报道了1例接受化疗的患者在肿瘤假体植入后发生急性SCFE的罕见病例.一名10岁的右股骨远端骨肉瘤女孩接受了（新）辅助化疗，广泛的肿瘤切除术，使用生长的肿瘤假体和短的非骨水泥股骨柄进行重建。植入后半年，她出现了无菌性松动。使用羟基磷灰石（HA）涂层的无骨水泥股骨柄进行翻修手术。术后X线平片显示SCFE经闭合复位和螺钉固定治疗。病人恢复了,没有出现并发症,未受影响的髋关节在随访中没有影像学表现。植入肿瘤假体的力量，特别是使用非胶结的茎，会增加急性SCFE的风险。在与化疗相关的SCFE中预防性固定未受累的髋关节的争议尚未解决。只有在存在异常的前驱放射学发现的情况下，才能考虑固定。
