[Results of surgical treatment for moderate or severe slipped capital femoral epiphysis through the approach of surgical hip dislocation].

OBJECTIVE: To evaluate the results of surgical treatment for moderate or severe slipped capital femoral epiphysis (SCFE) using modified Dunn procedure through the approach of surgical hip dislocation at the interval of minimum 12 months follow-up.

METHODS: From November 2011 to June 2013, 6 patients (7 hips) with SCFE were treated in department of pediatric orthopedics, Hospital Affiliated to Shanghai Jiaotong University School of Medicine, they all had trauma history. The patients were aged from 10-15 years, mean 13.6 years. The duration of symptoms ranged from 4 to 35 days, average 14.2 days. The degree of slip was averagely 45% (25%-55%). In 6 patients (except right side of 1 case was treated in situ with cannulated screws) were surgically treated using modified Dunn procedure through the approach of surgical hip dislocation. Postoperatively the brace was used for immobilizing the hip for 4 weeks, then 4 weeks of bed traction combined with rehabilitation program of hip joint activity. Eight weeks later, the gradual touchdown weight bearing was being allowed.

RESULTS: The follow-up time ranged from 12 to 30 months, average 23.8 months. Six patients have been able to walk without crutches, no obvious limp. X-ray film showed femoral epiphysis line on the bit of good recovery, no appearance of avascular necrosis of the femoral head, joint space was normal. The Harris score of hip evaluation was 94.7 averagely, ranging 85-100, at the time of last follow-up.

CONCLUSIONS: Application of surgical treatment for moderate or severe SCFE with open reduction through the approach of surgical hip dislocation is a valid alternative method. The femoral head epiphysis can be capable of restoring anatomy, at present no case occurred avascular necrosis, and patients are satisfied with the function of the hip joint.