gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Transfixation of unstable slipped capital femoral Epiphysis (SCFE) with Kirschner-wires

Meeting Abstract

  • corresponding author K. Seller - Orthopädische Universitätsklinik Leipzig, Orthopädie, Leipzig
  • A. Wild - Leipzig
  • B. Westhoff - Düsseldorf
  • P. Raab - Würzburg
  • R. Krauspe - Düsseldorf

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP22

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/nov2005/05nov104.shtml

Published: June 13, 2005

© 2005 Seller et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

Text

Introduction

Slipped capital femoral epiphysis (SCFE) is the typical hip disorder in adolescents. Surgical treatment is necessary in every case. However there is an ongoing controverse discussion about the implants for stabilization and the need of prophylactic treatment of the contralateral side.

Material and methods

Twenty-nine patients with unstable (acute) slipped capital femoral epiphysis (SCFE) were treated between 1990-1999 by indirect reduction and internal fixation of the epi- and metaphysis with 3-4 Kirschner-wires as well on the affected as also at the not (yet) affected side. After a mean follow-up of 3 ½ years there were overall good clinical results applying the score of Heyman and Herndon.

Results

Out of 29 patients with an average follow-up of 3 ½ years we had according to the classification of Heyman and Herndon 18 excellent (62,1%), 9 good (31,1%), 1 fair (3,4%) and 1 poor (3,4%) results. The rate of severe complications like avascular necrosis of the femoral head (AVN) and chondrolysis was low in our series (6,8% respectively 0%) compared to other series with different implants (screws, nails). AVN occurred only at the affected, but not at the prophylactically pinned hip. There were no further complications like infections, implant failure or problems with hardware removal.

Conclusion

We recommend the simultaneous transfixation of the epi- and metaphysis with Kirschner-wires in patients with unstable SCFE as therapeutic method for the affected as well as prophylactic treatment for the nondisplaced contralateral side. With this technique the slip can efficiently be stabilized and further slippage or any progression can reliably be prevented. Remodelling of the joint leads to an optimal sphericity and improved femoral neck length at the end of growth with a high rate of excellent and good clinical results.