We present a case of epiphyseal reperfusion in a 12-year-old boy following subcapital realignment of a unstable slipped capital femoral epiphysis. The case demonstrates that even if delayed, anatomical surgical realignment of the femoral head can be successful in preserving or reestablishing blood flow to the femoral epiphysis.
KelseyJ.L., KeggiK.J., SouthwickW.O.The incidence and distrubition of slipped capital femoral epiphysis in Connecticut and Southwestern United States.J Bone Joint Surg Am1970; 52: 1203–16.
2.
LoderR.T.Unstable slipped capital femoral epiphysis.J Pediatr Orthop2001; 21: 694–9.
3.
KallioP.E., MahE.T., FosterB.K., PatersonD.C., LeQuesneG.W.Slipped capital femoral epiphysis. Incidence and clinical assessment of physeal instability.J Bone Joint Surg Br1995; 77: 752–5.
4.
AadalenR.J., WeinerD.S., HoytW., HerndonC.H.Acute slipped capital femoral epiphysis.J Bone Joint Surg Am1974; 56: 1473–87.
5.
KennedyJ.G., HreskoM.T., KasserJ.R.. Osteonecrosis of the femoral head associated with slipped capital femoral epiphysis.J Pediatr Orthop2001; 21: 189–93.
6.
LoderR.T., RichardsB.S., ShapiroP.S., ReznickL.R., AronsonD.D.Acute slipped capital femoral epiphysis: the importance of physeal stability.J Bone Joint Surg Am1993; 75: 1134–40.
7.
PetersonM.D., WeinerD.S., GreenN.E., TerryC.L.Acute slipped capital femoral epiphysis: the value and safety of urgent manipulative reduction.J Pediatr Orthop1997; 17: 648–54.
8.
RatteyT., PiehlF., WrightJ.G.Acute slipped capital femoral epiphysis. Review of outcomes and rates of avascular necrosis.J Bone Joint Surg Am1996; 78: 398–402.
9.
RhoadR.C., DavidsonR.S., HeymanS., DormansJ.P., DrummondD.S.Pretreatment bone scan in SCFE: a predictor of ischemia and avascular necrosis.J Pediatr Orthop1999; 19: 164–8.
10.
ZiebarthK., ZilkensC., SpencerS., LeunigM., GanzR., KimY.J.Capital realignment for moderate and severe SCFE using a modified Dunn procedure.Clin Orthop Relat Res2009; 467: 704–16.
11.
AronssonD.D., LoderR.T.Treatment of the unstable (acute) slipped capital femoral epiphysis.Clin Orthop Relat Res1996; 322: 99–110.
12.
DietzF.R.Traction reduction of acute and acute-on-chronic slipped capital femoral epiphysis.Clin Orthop Relat Res1994; 302: 101–10.
13.
KramerW.G., CraigW.A., NoelS.Compensating osteotomy at the base of the femoral neck for slipped capital femoral epiphysis.J Bone Joint Surg Am1976; 58: 796–800.
MercatiE., GuaryA., MyquelC., BourgeonA.[A postero-external approach to the hip joint. Value of the formation of a digastric muscle] [Article in French].J Chir (Paris)1972; 103: 499–504.
16.
GanzR., GillT.J., GautierE., GanzK., KrugelN., BerlemannU.Surgical dislocation of the adult hip a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis.J Bone Joint Surg Br2001; 83: 1119–24.
17.
LeunigM., SlongoT., KleinschmidtM., GanzR.Subcapital correction osteotomy in slipped capital femoral epiphysis by means of surgical hip dislocation.Oper Orthop Traumatol2007; 19: 389–410.
18.
LeunigM., SlongoT., GanzR.Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis.Instr Course Lect2008; 57: 499–507.
19.
NotzliH.P., SiebenrockK.A., HempfingA., RamseierL.E., GanzR.Perfusion of the femoral head during surgical dislocation of the hip. Monitoring by laser Doppler flowmetry.J Bone Joint Surg Br2002; 84: 300–4.
20.
OramV.Epiphysiolysis of the head of the femur; a follow-up examination with special reference to end results and the social prognosis.Acta Orthop Scand1953; 23: 100–20.
21.
CarneyB.T., WeinsteinS.L., NobleJ.Long-term follow-up of slipped capital femoral epiphysis.J Bone Joint Surg Am1991; 73: 667–74.
22.
BonnaireF., SchaeferD.J., KunerE.H.Hemarthrosis and hip joint pressure in femoral neck fractures.Clin Orthop Relat Res1998; 353: 148–55.
23.
VegterJ., LubsenC.C.Fractional necrosis of the femoral head epiphysis after transient increase in joint pressure. An experimental study in juvenile rabbits.J Bone Joint Surg Br1987; 69: 530–5.
24.
GanzR., HuffT.W., LeunigM.Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application.Instr Course Lect2009; 58: 241–55.