Surgical Management of Unstable Superior Femoral Epiphysiolysis with Great Displacement  

作　　者：Kalifa Coulibaly Cheick Oumar Sanogo Mahamdou Diallo Abdoul Kadri Moussa Laye Toure Soumana Traore Aboubacar Diallo Sory Ibrahim Tambassi Souleymane Diallo Ousmane Traoré Kalifa Coulibaly;Cheick Oumar Sanogo;Mahamdou Diallo;Abdoul Kadri Moussa;Laye Toure;Soumana Traore;Aboubacar Diallo;Sory Ibrahim Tambassi;Souleymane Diallo;Ousmane Traoré(Orthopaedic Trauma Department, Kati University Hospital, Koulikoro, Mali;Orthopaedic Trauma Department, Gabriel Touré University Hospital, Bamako, Mali;Orthopedic Trauma Department, Sikasso Regional Hospital, Sikasso, Mali)

机构地区：[1]Orthopaedic Trauma Department, Kati University Hospital, Koulikoro, Mali [2]Orthopaedic Trauma Department, Gabriel Touré University Hospital, Bamako, Mali [3]Orthopedic Trauma Department, Sikasso Regional Hospital, Sikasso, Mali

出　　处：《Open Journal of Orthopedics》2023年第4期173-181,共9页矫形学期刊（英文）

摘　　要：Introduction: Superior femoral epiphysiolysis (SFE) is a most progressive but sometimes abrupt displacement of the femoral head relative to the superior femoral metaphysis through the cervicocerebral growth plate of the femur. The displacement of the femoral head is most often downward and backward. It is a typical pathology of the pubescent adolescent, most often overweight. It occurs on average at the age of 12 years in girls and 14 years in boys. Unstable forms with large displacements have a high risk of femoral head necrosis and chondrolysis. Although in situ fixation is the generally accepted treatment for minor SFE, the treatment of more severe cases remains controversial. When the extent of the displacement makes it impossible to pass a screw between the femoral neck and the femoral head, the only option is to reduce the displacement. This reduction must be gentle, progressive and limited to the minimum necessary for osteosynthesis. Objective: The aim of the work was to evaluate the results of the technique of progressive reduction of epiphyseal displacement by transtibial traction followed by percutaneous fixation of the femoral head by screw. Patients and Method: This was a retrospective descriptive study over a 10-years period from January 1, 2013 to December 31, 2022. It focused on the surgical treatment of unstable upper femoral epiphysiolysis with large displacement in the orthopaedic trauma department of the University Hospital of Kati. All patients operated on in our department for large displacement SFE were included in this study. Cases of secondary large displacement upper femoral epiphysiolysis and patients who had already undergone surgery on the proximal femur were excluded. Continuous progressive traction on the Boppe splint through a pin under the anterior tibial tuberosity was performed for 15 days in all patients. The hip was flexed to 45° and the knee to 35°. Fixation was performed with one or two screws. No contralateral preventive fixation was performed. Minimum follow-up was one yeIntroduction: Superior femoral epiphysiolysis (SFE) is a most progressive but sometimes abrupt displacement of the femoral head relative to the superior femoral metaphysis through the cervicocerebral growth plate of the femur. The displacement of the femoral head is most often downward and backward. It is a typical pathology of the pubescent adolescent, most often overweight. It occurs on average at the age of 12 years in girls and 14 years in boys. Unstable forms with large displacements have a high risk of femoral head necrosis and chondrolysis. Although in situ fixation is the generally accepted treatment for minor SFE, the treatment of more severe cases remains controversial. When the extent of the displacement makes it impossible to pass a screw between the femoral neck and the femoral head, the only option is to reduce the displacement. This reduction must be gentle, progressive and limited to the minimum necessary for osteosynthesis. Objective: The aim of the work was to evaluate the results of the technique of progressive reduction of epiphyseal displacement by transtibial traction followed by percutaneous fixation of the femoral head by screw. Patients and Method: This was a retrospective descriptive study over a 10-years period from January 1, 2013 to December 31, 2022. It focused on the surgical treatment of unstable upper femoral epiphysiolysis with large displacement in the orthopaedic trauma department of the University Hospital of Kati. All patients operated on in our department for large displacement SFE were included in this study. Cases of secondary large displacement upper femoral epiphysiolysis and patients who had already undergone surgery on the proximal femur were excluded. Continuous progressive traction on the Boppe splint through a pin under the anterior tibial tuberosity was performed for 15 days in all patients. The hip was flexed to 45° and the knee to 35°. Fixation was performed with one or two screws. No contralateral preventive fixation was performed. Minimum follow-up was one ye

关 键 词：Epiphysiolysis UNSTABLE Femoral Head Continuous Traction 

分 类 号：R68[医药卫生—骨科学]