Slipped capital femoral epiphysis. A prospective study of fixation with a single screw.

Aronson, David D.; Carlson, W E

doi:10.2106/00004623-199274060-00002

Cited by 206 publications

(105 citation statements)

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“…Na literatura não existe concordância em relação ao melhor método de tratamento para o EEPF com deslizamentos superiores ao de 30 o (5,(14)(15)(16)(17) . Porém, é consenso que, qual seja o tratamento escolhido, este é de difícil execução e sujeita a várias complicações.…”

Section: Discussionunclassified

“…Alguns autores descreveram bons resultados finais com a fixação in situ com parafuso canulado único, mesmo em escorregamentos graves, justificando que o potencial de remodelação óssea do fêmur proximal seria suficiente para restabelecer uma boa função à articulação do quadril (1)(2)18) , mas essa conduta não é respaldada em outros trabalhos (3,17) .…”

Section: Discussionunclassified

“…Aronson et al, em série de 80 quadris fixados in situ, com acompanhamento médio de 3,3 anos, obtiveram 70% de resultados excelentes e bons (17) . Entretanto, quando dividiram os quadris pelo grau de deslizamento, observaram 86% de resultados excelentes e bons nos escorregamentos leves, 55% nos casos moderados e apenas 27% nos casos graves.…”

Section: Discussionunclassified

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Osteotomia triplanar no tratamento do escorregamento epifisário proximal do fêmur

Kropf¹,

Júnior²,

Rabello³

et al. 2008

Rev. bras. ortop.

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Section: Discussionunclassified

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Osteotomia triplanar no tratamento do escorregamento epifisário proximal do fêmur

Kropf¹,

Júnior²,

Rabello³

et al. 2008

Rev. bras. ortop.

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“…This is a less accurate technique, as the reference radiopaque staples will inevitably move when the reduction is made and traction is applied to the skin edges. Aronsson and Carlsson [3] used a marker pen instead of staples in the treatment of slipped femoral epiphysis but found similar disadvantages. Then Schep [21] and Browbank [5] further described in vitro techniques using fluoroscopy-based navigation to estimate the position of the guide wire in the DHS fixation.…”

Section: Introductionmentioning

confidence: 99%

A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically

Sheng

Chen

et al. 2008

International Orthopaedics (SICOT)

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The goal of this study was to confirm the decrease in radiation time required for a new technique to place dynamic hip screws (DHS) in intertrochanteric fractures. Seventy-six patients were treated with DHS by either the new technique (NT) or the conventional technique (CT). The width of femoral shaft, the length of the hip screw to be implanted into the injured side, and the distance between the tip of the greater trochanter and the entry point of the guide wire were measured at the uninjured side on the anteroposterior pelvic radiograph preoperatively, and the actual width of the injured femoral shaft was measured intra-operatively. Finally, the entry point and the length of hip screw were obtained through an equation. Mean radiation time of the NT patients (24.57±7.80 s) was significantly shorter than the CT patients (54.2±18.26 s) (P <0.001). The new technique decreased radiation time dramatically in DHS fixation.Résumé Le but de cette étude est d'évaluer la diminution du temps d'exposition aux rayons X par une nouvelle technique de vissage dynamique de la hanche DHS (NT) comparée à la technique conventionnelle. Matériel et méthode: 76 patients ont été traités par DHS avec cette nouvelle technique (NT) ou la technique conventionnelle (CT). La largeur et la longueur de la vis fémorale implantée et la distance entre le sommet du grand trochanter et le point d'entrée du guide ont été mesurés du côté fracturé par une radiographie de face pré-opératoire et per-opératoire. Finalement, le point d'entrée et la longueur de la vis fémorale sont obtenus par équation. Résultats : l'exposition moyenne aux rayons X de la nouvelle technique (24.57± 7.80s) a été significativement moins importante que dans la technique conventionnelle (54.2±18.26 s) (P<0.001). En conclusion, cette nouvelle technique permet de diminuer le temps d'irradiation de façon importante, lors d'une fixation de fracture fémorale par DHS.

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“…Several treatment methods have been described, such as single screw fixation [5][6][7][8], multiple screws [9,10], pinning [11,12], open epiphyseodesis [13,14], osteotomies [15], manipulation [16,17] and even non-operative treatment [18].…”

Section: Introductionmentioning

confidence: 99%

Screw placement in slipped upper femoral epiphysis: Is good the enemy of better?

Jamil

Allami

Varghese

et al. 2007

Journal of Children's Orthopaedics

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Introduction and aims A single hip screw is the recommended method of fixation for slipped upper femoral epiphysis (SUFE). Current practice favours the placement of the screw in the centre of the femoral head on both anteroposterior and lateral planes to avoid the risks of chondrolysis and avascular necrosis (AVN). We investigated the correlation between different positions of the screw in the femoral head and the prevalence of AVN, chondrolysis, late slippage and the time to epiphyseal closure.Methods The clinical notes and radiographs of 38 consecutive patients (61 hips) who underwent single screw fixation for SUFE were evaluated retrospectively with a mean follow-up of 36 months. Two-way ANOVA and the post hoc test was performed to analyse the correlation between the different variables and the outcome at the 5% level of significance.Results There were 16 acute slips, 18 chronic slips and ten acute-on-chronic slips. Seventeen slips were treated prophylactically. Mild slip was encountered in 39 hips, moderate slip in four and severe slip in one. The centralcentral position was only achieved in 51% of cases. The most significant results of the study were as follows: (1) no significant difference between the time to epiphyseal closure and the position of the screw, and (2) no late slippage or chondrolysis was observed in our series.Conclusion Our results showed that the positioning of the screw other than in the centre of the femoral head has the ability to provide physeal stability and has no correlation with the timing to closure of the epiphysis and the risk of avascular necrosis or chondrolysis. We therefore recommend that other positions be considered if the ''optimal central-central position'' is not initially achieved -specifically for the treatment of mild slip -as the potential hazards from several attempts to achieve the optimum position outweigh the benefits.

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Slipped capital femoral epiphysis. A prospective study of fixation with a single screw.

Cited by 206 publications

References 0 publications

Osteotomia triplanar no tratamento do escorregamento epifisário proximal do fêmur

Osteotomia triplanar no tratamento do escorregamento epifisário proximal do fêmur

A new technique for lag screw placement in the dynamic hip screw fixation of intertrochanteric fractures: decreasing radiation time dramatically

Screw placement in slipped upper femoral epiphysis: Is good the enemy of better?

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