[Late results of subcapital linear osteotomy in epiphysiolysis capitis femoris juvenilis (author's transl)]

Abstract

107 patients with separation of the head of the femoral epiphysis were treated surgically at the Marburg Orthopaedic University Hospital during the 1955--1975 period. Followup examinations were performed in 69 patients. 34 of these had been subjected to subcapital linear osteotomy. On the average the operation had been performed 7.64 years ago. Early results were good. In most cases it was possible to correct the malposition caused by the slipping. Necroses of the femoral head were not seen more frequently than with most other methods. Necrosis of the femoral head occurred four times after 35 linear osteotomies in 34 patients. Definite roentgenological signs of arthrosis were seen about 2--3 years after the opration. These changes increased with increasing interval between operation and examination. Subcapital linear osteotomy cannot prevent the development of early arthrosis in cases where separation of the head of the femoral epiphysis exceeds 30 degrees. Despite this limitation, the patients examined during the followup study revealed a clinically favourable picture with good functioning and very considerable freedom from symptoms; it must be borne in mind in this connection that all patients were still under 35 years of age.