Cuneiform osteotomy of femoral neck as treatment for slipped capital femoral epiphysis sequelae

Abstract

Introduction Abnormal hip anatomy of untreated Slipped Capital Femoral Epiphysis (SCFE), a prototype of cam impingement deformity, is a cause of early hip degeneration. Objective To describe an original technique of cuneiform osteotomy of the femoral neck to relocate femoral epiphysis in patients with sequelae of SCFE. Methods Seven hips in 6 male patients with sequelae of severe SCFE, with a mean age of 15 years (13–16), and with a mean of 9.2 months of hip pain and severe limp, were treated. All of the cases had closed growth cartilage at the time of consultation. Surgical technique and results In all cases we performed a cuneiform osteotomy of the femoral neck with relocation of epiphysis. A dissection and elevation of cervical periosteum to protect the epiphyseal vessels of the femoral head was performed. Then, the cuneiform osteotomy of the femoral neck was performed with relocation of the femoral epiphysis to the anatomical position and osteosynthesis. We achieved an epiphyseal-shaft angle correction from 66° preoperative to 11° postoperative. The mean follow up was 37 months (4–59). Conclusion Cuneiform osteotomy of the femoral neck proposed in patients with sequelae of SCFE is an alternative treatment that achieves good anatomical and imaging results in young patients.