Baraka, Mostafa M.Hefny, Hany M.Thakeb, Mootaz F.Fayyad, Tamer A.Abdelazim, HaythamHefny, Mamdouh HMahran, Mahmoud A.2023-11-272023-11-272020-06Baraka MM, Hefny HM, Thakeb MF, Fayyad TA, Abdelazim H, Hefny MH, Mahran MA. Combined Imhauser osteotomy and osteochondroplasty in slipped capital femoral epiphysis through surgical hip dislocation approach. J Child Orthop. 2020 Jun 1;14(3):190-200. doi: 10.1302/1863-2548.14.200021.1863-25211863-254810.1302/1863-2548.14.20002132582386http://hdl.handle.net/20.500.14200/2995Purpose: Treatment of moderate to severe stable slipped capital femoral epiphysis (SCFE) remains a challenging problem. Open reduction by modified Dunn procedure carries a considerable risk of osteonecrosis (ON). Imhauser osteotomy is capable of realigning the deformity without the risk of ON, but the remaining metaphyseal bump is implicated with significant chondro-labral lesions and accelerated osteoarthritis. We conducted this study to evaluate the efficacy and safety of Imhauser osteotomy combined with osteochondroplasty (OCP) through the surgical hip dislocation (SHD) approach. Methods: A prospective series of 23 patients with moderate-severe stable SCFE underwent Imhauser osteotomy and OCP through SHD. The mean age was 14.4 years (13 to 20) and the mean follow-up period was 45 months (24 to 66). The outcome measures included clinical and radiological parameters and Harris hip score (HHS) was used as a functional score. Results: The mean HHS improved significantly from 65.39 to 93.3. The limb length discrepancy improved by a mean of 1.72 cm. The mean flexion and abduction arcs showed a significant improvement (mean increase of 37.5° and 18.5°, respectively). The mean internal rotation demonstrated the most significant improvement (mean increase of 38.5°). All the radiographic parameters improved significantly; including anterior and lateral slip angles (mean improvement 37.52° and 44.37°, respectively). The mean alpha angle decreased by 39.19°. The articulo-trochanteric distance significantly increased to a mean of 23.26 mm. No cases of ON or chondrolysis were identified. Conclusion: Combined Imhauser osteotomy and OCP through the surgical dislocation approach provide a comprehensive and safe management of moderate to severe stable SCFE. Level of evidence: IV. Keywords: Imhauser osteotomy; hip impingement; hip preservation; slipped capital femoral epiphysis; surgical hip dislocation.enCreative Commons Attribution-NonCommercial 4.0 Internationalhttps://creativecommons.org/licenses/by-nc/4.0/OrthopaedicsSurgeryArticlehttps://westmid.openrepository.com/bitstream/handle/20.500.14200/2995/Combined%20Imhauser%20osteotomy%20and%20osteochondroplasty%20in%20slipped%20capital%20femoral%20epiphysis%20through%20surgical%20hip%20dislocation%20approach.pdf?sequence=2&isAllowed=y