Tratamiento del deslizamiento epifisiario capital femoral con fijación in situ versus luxación quirúrgica

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instname:Universidad del Rosario

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Hernández Olaya, Carlos Alberto; Especialista en Ortopedia y Traumatología HOK
Facultad de Medicina; Universidad del Rosario
Deslizamiento epifisiario capital femoral; fijacion in situ; luxacion quirurgica controlada; DESLIZAMIENTO EPIFISIARIO CAPITAL FEMORAL - TRATAMIENTO; Ortopedia; Traumatología; Slipped capital femoral epiphysis; in situ fixation; surgical dislocation controlled; LUXACIÓN DE LA CADERA – INVESTIGACIONES; LUXACIÓN DE LA CADERA - TRATAMIENTO; DESLIZAMIENTO EPIFISIARIO CAPITAL FEMORAL – INVESTIGACIONES; ORTOPEDIA – INVESTIGACIONES; TRAUMATOLOGÍA – INVESTIGACIONES
thesis / dissertation description
Introduction: Capital Femoral epiphyseal slippage is the most common disease in adolescents from 9 to 16 years. It´s idiopathic, more common in males, and is classified in four stages according to clinical and radiological criteria. We assess the development of moderate and severe landslides treated with one of the two techniques. Methods We performed a retrospective study with patients treated with fixation in situ or controlled surgical dislocation from 2008 to 2011. Results: We included 26 patients, of whom 65.4% received controlled surgical dislocation and 34.6% in situ fixation. The patients 70.6% had unstable DECF and 70.5% had severe displacement. The evaluation of WOMAC scale for pain, stiffness and functional ability, showed better results with de fixation in situ, statistically significative (p<0,05) not only for the pai, stiffness and functional ability but fewer complications. The most frecuent complications in patients who underwent surgical dislocation controlled were one case of surgical site infection, 7 cases (41.2%) of avascular necrosis of the femoral head, 5 cases (29.4%) of chondrolysis of the hip and 2 cases (11.8%) of nonunion; with the fixation in situ, only 1 (11.1%) had surgical site infection and 1 (11.1%) hip chondrolysis. Discussion: Patients with moderate and severe landslides handled with in situ fixation had better functional scale with lower rate of complications.