Chronic SUFE Management - Ian McDermott 21/2/2002

Brief

DUNN JBJS-Br 1978

Author

Dunn DM & Angel JC

Title

Replacement of the femoral head by open operation in severe adolescent slipping of the upper femoral epiphysis

Reference

JBJS 1978; 60-B (3): 394 – 403

Summary

11% subjectively poor, 16% clinically poor, 27% X-rays poor.

If growth plate closed, or acute on chronic, then -> poor results

Critique

73 procedures. Mixture of acute on chronic & chronic. 17 had previous ops elsewhere 1 st . “several” had had manipulation or prolonged traction elsewhere first.

Brief

IRELAND and NEWMAN JBJS-Br 1978

Author

Ireland J & Newman PH

Title

Triplane osteotomy for severely slipped upper femoral epiphysis

Reference

JBJS 1978; 60-B (3): 390 – 393

Summary

¾ good clinical results. No AVN.

Critique

35 osteotomies. Mean duration Sx 8m. slip ≥ ⅓. Only 2 poor clinically, 4 poor X-rays. 4 chondrolysis. No AVN. Frequent inadequate correction in lateral view, over correction in valgus.

Brief

CIGALA Ital J Orthop Traumatol 1984

Author

Cigala F & Sadile F

Title

Southwick’s osteotomy in the treatment of chronic slipped upper femoral epiphysis. Fixation with AO blade plate.

Reference

Ital J Orthop Traumatol 1984; 10(4): 461-8

Summary

No poor or fair results. No AVN. Only 1 chondrolysis (was “reversible”). Mean final shortening only 0.7cm.

Critique

17 cases. Pain for ~3/12 pre-op. Minimum FU 10 months. Max FU 4 years (mean not given).

Brief

FINESCHI Int Orthop 1986

Author

Fineschi G & Guzzanti V

Title

Linear intertrochanteric osteotomy for chronic slip of the upper femoral epiphysis

Reference

Int Orthop 1986; 10(2): 83 – 88

Summary

86% ‘excellent’, remainder stiff only. No AVN

Critique

21 cases. Essentially = Southwick technique. Minimum FU 4 years. Lack of description of assessment.



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