A comparative study of blade plate fixation and external fixation in osteotomies for slipped capital femoral epiphysis

Abstract

We have performed corrective osteotomies for moderate or severe slipped capital femoral epiphysis (SCFE) using an original blade plate (BP) until 2006 and using a hybrid external fixator (EF) since 2007. We designed a comparative study of the short-term results between BP and EF devices in the treatment of proximal femoral osteotomies in SCFE. Nineteen SCFE patients (12 BP; seven EF) who underwent corrective osteotomies at our institution were included. Clinical and radiographic valuables including the operative time, intraoperative blood loss, postoperative improvement of head shaft angle, and posterior tilting angle, Harris hip score, limb-length discrepancy, and associated complications were compared between the two groups. Although there were no significant differences between the two groups in postoperative improvement of head shaft angle and posterior tilting angle, Harris hip score, and limb-length discrepancy, the EF group showed significantly shorter operative time and less intraoperative blood loss. Serious complications were observed in two patients of the BP group (deep infection and chondrolysis, respectively) and one of the EF group (chondrolysis). Percutaneous proximal femoral osteotomy using an EF appears to be safe, easy, and effective in correcting multiplanar deformities associated with SCFE. It has potential advantages over commonly used open techniques in terms of simplicity and less invasiveness.