In situ pinning in slipped capital femoral epiphysis: long-term follow-up studies.

BACKGROUND: Management of moderately displaced slipped capital femoral epiphysis (SCFE) is debated, mostly because of the risks related to open reduction on one hand, and subsequent evolution toward femoroacetabular impingement (FAI) on the other. METHOD: All SCFE cases treated with in situ fixation (ISF) and a minimum of ten years of follow-up beyond skeletal maturity were analysed in a retrospective multicentre study. Coxometry parameters were measured. Long-term results of ISF were meanwhile analysed at our Institution. RESULTS: A total of 222 patients were included. Patient reported outcome measurements were related to the severity of the initial slip. It suggested a 35.5° threshold for slip angle beyond which FAI was more frequent. Only slight remodelling at the head-neck junction is to be expected. CONCLUSION: Based on these findings, it seems reasonable to perform ISF only in SCFE with a slip angle below 35°.

[Deep lesion of the femoral artery and fracture of the femoral diaphysis. Value of selective embolization]. / Lésion de l'artère fémorale profonde et fracture de la diaphyse fémorale. Intérêt de l'embolisation sélective.

The authors report a case of an osteosynthesized fracture of the femoral shaft with a lesion of the deep femoral artery revealed at a late stage by sudden appearance of a hematoma. A diagnostic arteriogram was performed, followed by therapeutic embolization: temporary hemostasis was achieved by the hyper-selective injection of Gelfoam, thus allowing anti-coagulant therapy for associated venous thrombosis to be continued, without abnormal delay in bone consolidation.