Surgical Management of Unstable Superior Femoral Epiphysiolysis with Great Displacement

Introduction: Superior femoral epiphysiolysis (SFE) is a most progressive but sometimes abrupt displacement of the head relative to superior metaphysis through cervicocerebral growth plate femur. The often downward and backward. It typical pathology pubescent adolescent, overweight. occurs on average at age 12 years in girls 14 boys. Unstable forms with large displacements have high risk necrosis chondrolysis. Although situ fixation generally accepted treatment for minor SFE, more severe cases remains controversial. When extent makes it impossible pass screw between neck head, only option reduce displacement. This reduction must be gentle, limited minimum necessary osteosynthesis. Objective: aim work was evaluate results technique epiphyseal by transtibial traction followed percutaneous screw. Patients Method: retrospective descriptive study over 10-years period from January 1, 2013 December 31, 2022. focused surgical unstable upper orthopaedic trauma department University Hospital Kati. All patients operated our SFE were included this study. Cases secondary who had already undergone surgery proximal femur excluded. Continuous Boppe splint pin under anterior tibial tuberosity performed 15 days all patients. hip flexed 45° knee 35°. Fixation one or two screws. No contralateral preventive performed. Minimum follow-up year. Functional outcome assessed Postel Merle d’Aubigné score. Anatomical quality reduction, occurrence non-occurrence necrosis, Results: We identified nine mean 12.8 extremes 9 17 years. There three boys six girls. Trauma mentioned four cases. cause idiopathic five impotence complete slippage acute chronic background left side affected 7 right 2 overweight patient’s weight within normal range At final follow-up, asymptomatic. Anatomically, free avascular necrosis. In eight patients, posterior tilt absent, identical that obtained after period. Only patient moderate uncovering less than 25%. Functionally, PMA score very good case. Conclusion: shows can lead satisfactory results. Reduction should Magnetic resonance imaging examination an essential indispensable prognostic element. Indications selectively reserved specific