Valgus Slipped Capital Femoral Epiphysis: Pathophysiology of Movement and Outcomes of Intracapsular Realignment.
J Orthop Trauma. 2018 Feb;32 Suppl 1:S5-S11
Authors: Kalhor M, Gharanizadeh Ok, Rego P, Leunig M, Ganz R
OBJECTIVES: The aim of this examine was to report (1) a distinct however particular sample of impingement in hips concerned with valgus slipped capital femoral epiphysis (valgus SCFE) and (2) the outcomes of surgical therapy utilizing intracapsular realignment methods.
DESIGN: Case sequence.
SETTING: A number of educational facilities.
PATIENTS: Six sufferers with eight concerned hips referred for valgus alignment of proximal femoral epiphysis (valgus SCFE).
INTERVENTION: Intracapsular realignment osteotomy mixed with periacetabular osteotomy if wanted.
MAIN OUTCOME MEASUREMENT: The scientific and radiographical outcomes and pathophysiology of movement.
RESULTS: Eight hips in 6 sufferers have been handled with subcapital (5 hips) or femoral neck (three hips) osteotomy for realignment. The medially outstanding metaphysis created an inclusive impingement on the anterior acetabular wall, whereas the excessive coxa valga favored impacting impingement on the posterior head-neck junction. The imply preoperative epiphyseal-shaft angle of 110.5 (vary 90-125 levels) was diminished to 62 levels (vary 55-70 levels) postoperatively. On the final follow-up, all however 1 hip have been pain-free and impingement-free, with regular vary of movement. One hip was changed after repeated makes an attempt of correction. The general hip practical consequence utilizing modified Merle d’Aubigne scoring system was wonderful in 5 hips (18-16 factors), good in 2 hips (16-15 factors), and poor in 1 hip (6 factors).
CONCLUSIONS: Impingement in valgus SCFE deformity is particular and complicated. Anatomical realignment can result in favorable outcomes by the restoration of regular morphology and impingement-free vary of movement.
LEVEL OF EVIDENCE: Therapeutic Degree IV. See Directions for Authors for a whole description of ranges of proof.
PMID: 29373445 [PubMed – in process]