DOS 2016

DOS Kongressen 2016 ·

187

Introduction of open reduction for severe Slipped

Capital Femoral Epiphysis using the sub capital

realignment procedure after surgical dislocation of

the hip joint

Martin Gottliebsen, Mathias Bünger, Ole Rahbek, Bjarne Møller-Madsen

Department of Children’s Orthopaedics, Aarhus University Hospital

Background:

Slipped Capital Femoral Epiphysis (SCFE) is a condition that af-

fects the hips in older children and adolescents. Current treatment is primarily

based on in situ fixation using a single cannulated screw. The sub capital realign-

ment osteotomy of the neck of femur for severe SCFE is gaining increasing ac-

ceptance. Anatomical realignment is performed after surgical dislocation of the

affected hip joint. The procedure carries a risk for inducing avascular necrosis of

the femoral head

Purpose / Aim of Study:

To present early experience with a new setup for

treating severe SCFE using new techniques for osteotomies of the proximal fe-

mur at Department of Children’s Orthopaedics, Aarhus University Hospital

Materials and Methods:

Two osteotomies were performed in the following

cases; severe acute on chronic SCFE in a 10 year girl and severe chronic SCFE

in a 12 year girl. The sub capital realignment procedure was performed in both

cases as described above. Perfusion of the femoral head was documented by

either SPECT scan (Bonescan) or intraoperative monitoring of blood flow in the

femoral head using a Codman Intra Cranial Pressure (ICP) probe

Findings / Results:

The 10 year old girl, who was treated for severe acute on

chronic SCFE had no AVN on postoperative SPECT scan. She was fully weight

bearing 3 months after surgery without pain and ROM was almost restored at

this stage. The final case underwent surgery 13 June 2016. We were able to

perform intraoperative monitoring of blood flow in the femoral head using the

ICP probe during the procedure. The femoral head was perfused throughout the

procedure

Conclusions:

These are early positive results of a new surgical procedure.

Internationally there is a trend towards restoration of the hip anatomy for se-

vere SCFE. We recommend that further use of this surgical procedure takes

place in a national prospective study

No conflicts of interest reported

138.