Radiological evidence of femoroacetabular impingement in mild slipped capital femoral epiphysis
Open Access
- 1 December 2007
- journal article
- research article
- Published by British Editorial Society of Bone & Joint Surgery in The Journal of Bone and Joint Surgery. British volume
- Vol. 89-B (12), 1592-1596
- https://doi.org/10.1302/0301-620x.89b12.19637
Abstract
Conventional treatment of mild slipped capital femoral epiphysis consists of fixation in situ with wires or screws. Recent contributions to the literature suggest that even a mild slip may lead to early damage of the acetabular labrum and adjacent cartilage by abutment of a prominent femoral metaphysis. It has been suggested that the appropriate treatment in mild slipped capital femoral epiphysis should not only prevent further slipping of the epiphysis, but also address potential femoroacetabular impingement by restoring the anatomy of the proximal femur. Between October 1984 and December 1995 we treated 16 patients for unilateral mild slipped capital femoral epiphysis by fixation in situ with Kirschner wires. In this study we have reviewed these patients for clinical and radiological evidence of femoroacetabular impingement. There was little clinical indication of impingement but radiological evaluation assessing the femoral head-neck ratio and measuring the Nötzli α angle on the anteroposterior and cross-table radiographs showed significant alterations in the proximal femur. None of the affected hips had a normal head-neck ratio and the mean α angle was 86° (55° to 99°) and 55° (40° to 94°) on the anteroposterior and lateral cross-table radiographs, respectively. While our clinical data favours conventional treatment, our radiological findings are in support of restoring the anatomy of the proximal femur to avoid or delay the development of femoroacetabular impingement following mild slipped capital femoral epiphysis.Keywords
This publication has 37 references indexed in Scilit:
- Comparison of Six Radiographic Projections to Assess Femoral Head/Neck AsphericityPublished by Ovid Technologies (Wolters Kluwer Health) ,2006
- Current concepts in the management of femoroacetabular impingementThe Journal of Bone and Joint Surgery. British volume, 2005
- Debridement of the Adult Hip for Femoroacetabular ImpingementPublished by Ovid Technologies (Wolters Kluwer Health) ,2004
- Femoroacetabular impingement caused by a femoral osseous head–neck bump deformity: clinical, radiological, and experimental resultsJournal of Orthopaedic Science, 2004
- Anterior Femoroacetabular ImpingementPublished by Ovid Technologies (Wolters Kluwer Health) ,2004
- Surgical dislocation of the adult hipThe Journal of Bone and Joint Surgery, 2001
- Classification in Slipped Capital Femoral EpiphysisClinical Orthopaedics and Related Research, 1993
- Rating Systems in the Evaluation of Knee Ligament InjuriesClinical Orthopaedics and Related Research, 1985
- A Retrospective Study of 125 Cases of Slipped Capital Femoral EpiphysisPublished by Ovid Technologies (Wolters Kluwer Health) ,1982
- 5 Treatment Slipping of the Capital Femoral EpiphysisPublished by Ovid Technologies (Wolters Kluwer Health) ,1966