A method of surgical treatment of unstable severe forms of juvenile femoral head epiphysiolysis

Abstract

Aim. To analyze the long-term results of the designed method for the open epiphysis reduction in patients with severe unstable forms of juvenile femoral head epiphysiolysis. Methods. The article describes the method of surgical treatment of severe forms of unstable juvenile femoral head epiphysiolysis and long-term outcomes in 21 patients. The indications for the method were the unstable form of juvenile femoral head epiphysiolysis and slipped capital femoral epiphysis with a slip angle of more than 40 degrees. The age of patients at time of treatment ranged from 11 to 16 years, follow-up period - from 2 to 15 years. Five patients underwent a comprehensive biomechanical study within one year after surgery. Results. The early and late results of the femoral head epiphysis open reduction were analyzed. Positive results were obtained in 19 cases (good results in 17, satisfactory in 2). The complication rate was 14.3% and included 3 cases of avascular femoral head necrosis, no cases of chondrolysis were revealed. According to biomechanical examination data performed in five patients 1 year after the surgery, almost complete functional recovery of the musculoskeletal system was revealed. Conclusion. Analysis of the results showed that being properly executed the open reduction of the femoral head with a corrective femoral neck osteotomy allowed to restore normal anatomic proportions and function of the affected joint, positive result was maintained for the entire follow-up period.