Epifisiólisis de fémur proximal: resultados y calidad de vida

Juan Filippini; Ignacio Pagano; María Elena Pérez; Johan von Heideken†

doi:10.29193/RMU.36.3.4

Authors

Juan Filippini Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica
Ignacio Pagano Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica
María Elena Pérez Universidad de la República, Facultad de Medicina, Clínica de Traumatología y Ortopedia Pediátrica
Johan von Heideken† Suecia, Estocolmo, Instituto Karolinska, Departamento de Salud del Niño y de la Mujer

DOI:

https://doi.org/10.29193/RMU.36.3.4

Keywords:

SLIPPED CAPITAL FEMORAL EPIPHYSES, CHILD, QUALITY OF LIFE

Abstract

Introduction: the impact on the quality of life of patients with unstable and stable slipped capital femoral epiphysis is rather unknown. The study aims to learn about therapeutic outcomes in a quality of life score and the complications of the affected population in an orthopedics referecence center.
Method: this cohort study included 28 children treated at the Pereira Rossell Hospital Center between 2010 and 2016. Patients were assessed both clinically and with x-rays, with a 2-year minimum postoperative follow-up. The "International Hip Outcome Tool" (iHOT-12) questionnaire was used to measure the results reported by patients. Avascular necrosis, chondrolysis and femoroacetabular impingement were the complications evaluated by the study.
Results: the study identified 38 hips treated for slipped capital femoral epiphysis. 28 of them were classified as stable (74%) and 10 as unstable (26%). In-situ fixation was the most frequently used surgical treatment. Upon completion of follow-up, 27 patients were assessed and the iHOT12 showed a significant difference between stable and unstable slips (70 (range 38-95) and 86 (57-100); P=0,017) respectively. No avascular necrosis or chondrolysis were observed and femoroacetabular impingement was 19% (n=7 hips; 6 stable and 1 unstable).
Conclusions: quality of life clinical results obtained by PROM were significantly better in the unstable slipping epiphysis of the proximal femur than in the stable epiphysis. Absence of avascular necrosis in unstable hips and the greater proportion of femoroacetabular impingements in stable slips despite a noticeable femoral remodeling following in-situ fixation could explain these surprising results.

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