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Fixationstechniken bei der Epiphyseolysis capitis femoris

Prinzipien, operative Techniken und Komplikationen

Fixation techniques for slipped capital femoral epiphysis

Principles, surgical techniques, and complications

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Zusammenfassung

Dieser Beitrag soll eine Übersicht über Vor- und Nachteile sowie die Operationstechniken der gängigen Implantate zur Fixation der abgerutschten Hüftkopfepiphyse geben. Als solche zu nennen sind K-Drähte, Hansson-Pins sowie Schrauben bzw. Gleitschrauben. Hierzu führten wir eine Literaturrecherche in PubMed mit den Suchbegriffen „ECF“ und „SCFE“ in Kombination mit „in situ fixation“, „pin“, „wire“, „screw“ und „nail“ durch. Den Johansson-Nagel, Knowles-Pin und Nyström-Nagel stufen wir als historisch und abgelöst ein. In Hinblick auf die Aspekte Wachstumsstörung und Remodellierung zeigt sich ein Trend von der Zielsetzung der Epiphyseodese mit „absoluter Stabilität“ hin zur „dynamischen Fixation“.

Abstract

The purpose of this review is to present the pros and cons as well as the surgical techniques of conventional implants used for fixation of slipped capital femoral epiphysis (SCFE). Worth mentioning are K‑wires, Hansson pins, transfixing screws, and gliding screws. We searched PubMed for “ECF” and “SCFE” in combination with “in situ fixation,” “pin,” “wire,” “screw,” and “nail.” We considered Johansson nail, Knowles pin, and Nyström nail to be obsolete and of historical interest only. We noticed a trend from absolute stability towards some form of dynamic fixation over time, likely related to considerations of growth disturbance of the proximal femur and also the inherent potential for remodeling with time.

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Abbreviations

AO:

Arbeitsgemeinschaft für Osteosynthesefragen

AVN:

Avaskuläre Nekrose

CCD-Winkel:

Centrum-Collum-Diaphysen-Winkel

dGEMRIC:

„Delayed gadolinium-enhanced magnetic resonance imaging of cartilage“

ECF:

Epiphyseolysis capitis femoris

FAI:

Femoroacetabuläres Impingement

K-Drähte:

Kirschner-Drähte

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Authors and Affiliations

  1. Orthopädische Klinik, Universitätsklinikum Düsseldorf, Moorenstraße 5, 40225, Düsseldorf, Deutschland

    C. Lederer, B. Westhoff, B. Bittersohl & R. Krauspe

  2. Center for Hip Preservation and Children’s Orthopedics, San Diego, USA

    H. S. Hosalkar

  3. Department of Orthopedics, Skane University Hospital, Lund University, Lund, Schweden

    C. J. Tiderius

Authors
  1. C. Lederer
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  2. H. S. Hosalkar
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  3. C. J. Tiderius
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  4. B. Westhoff
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  5. B. Bittersohl
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  6. R. Krauspe
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Corresponding author

Correspondence to C. Lederer.

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Interessenkonflikt

C. Lederer, H. S. Hosalkar, C. J. Tiderius, B. Westhoff, B. Bittersohl und R. Krauspe geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Lederer, C., Hosalkar, H.S., Tiderius, C.J. et al. Fixationstechniken bei der Epiphyseolysis capitis femoris. Orthopäde 48, 659–667 (2019). https://doi.org/10.1007/s00132-019-03733-6

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