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Chronic slipped capital femoral epiphysis: a radiographic evaluation of the Southwick osteotomy

Lino, Wilson Jra; Akkari, Miguelb; Waisberg, Gilbertob; Braga, Susana R.b; Santili, Cláudiob,c

Journal of Pediatric Orthopaedics B: November 2013 - Volume 22 - Issue 6 - p 536–541
doi: 10.1097/BPB.0b013e3283651b48
Hip & Femur

The aim of this study was to evaluate the radiographic correction and the complications in Southwick osteotomy for slipped capital femoral epiphysis (SCFE) on the basis of radiographic evaluation. We retrospectively analyzed the charts of 37 patients with chronic, unilateral, moderate, or severe SCFE, who underwent the procedure, verifying Southwick angles, articulotrochanteric distance, and the articular narrowing on preoperative, postoperative periods, and in the last follow-up evaluation, using the contralateral, healthy hip, for comparison. Southwick’s angle changed from 117.8 to 147.3° on average (front) and from 56.9 to 19.1° (Lauenstein view). Articulotrochanteric distance changed from 11.3 to 24.1 mm (normal distance 22.1 mm). Joint space changed from 4.3 mm preoperatively to 3.84 mm. Chondrolysis was diagnosed in five cases before and eight cases after surgery. There was no case of avascular necrosis. Southwick osteotomy effectively corrected SCFE deformity. There was a tendency toward excessive valgism.

aSanta Casa de Misericórdia de São Paulo

bPediatric Orthopedic Group, Santa Casa de Misericórdia de São Paulo

cSchool of Medicine, Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil

Correspondence to Cláudio Santili, MD, PhD, Rua Mato Grosso, 306, cj. 1212, Higienópolis, CEP 01239-040 São Paulo (SP), Brazil Tel/fax: +55 11 3237 0085/2114 6090; e-mail: ortopedsantili@yahoo.com.br

© 2013 by Lippincott Williams & Wilkins, Inc.