EPIPHYSIOLYSIS WITH MAJOR DISPLACEMENT: ANTERIOR SURGICAL REDUCTION

Purpose: Treatment of femoral epiphysiolysis with major displacement remains a controversial subject. Open repositioning of the epiphysis via a lateral approach as proposed by Dunn allows nearly anatomic restitution but with a high rate of complications. We report our experience with open repositions via an anterior approach which has been more reliable in our hands.Material and methods: During the last decade, we operated nine hips for epiphysiolysis with major displacement, using the anterior approach to spare the medial circumflex artery. External reduction was not attempted. Preoperative and residual displacement were evaluated using the Southwick technique and according to the position of the femoral head in relation to the Klein line. Early after surgery, a bone scintigram was obtained for all hips. We followed these patients to bone maturity, with a mean follow-up of four years.Results: The early postoperative scintigrams did not reveal any case of insufficient uptake in the femoral head. Mean corr...