JOM KITA KE POLITEKNIK

Limited hip flexion and internal rotation resulting from early hip impingement conflict on anterior metaphysis of Patients with untreated Severe SCFE using 3D modelling (Record no. 511)

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Personal name Lerch, Till D.
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9 (RLIN) 3098
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Title Limited hip flexion and internal rotation resulting from early hip impingement conflict on anterior metaphysis of Patients with untreated Severe SCFE using 3D modelling
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Date of publication, distribution, etc. 2022-11-01.
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General note /pmc/articles/PMC7614193/
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General note /pubmed/36099440
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Summary, etc. INTRODUCTION: SCFE is the most common hip disorder in adolescent patients that can result in complex 3D-deformity and hip preservation surgery (e.g. in-situ-pinning or proximal femoral osteotomy) is often performed. But there is little information about location of impingement. Purpose/Questions The purpose of this study was to evaluate(1) impingement-free hip flexion and internal rotation(IR), (2)frequency of impingement in early flexion(30°-60°) and (3)location of acetabular and femoral impingement in IR in 90° of flexion(IRF-90°) and in maximal flexion for patients with untreated severe SCFE using preoperative 3D-CT for impingement-simulation. PATIENTS AND METHODS: A retrospective study involving 3D-CT scans of 18 patients(21 hips) with untreated severe SCFE(slip-angle>60°) was performed. Preoperative CT scans were used for bone segmentation of preoperative patient-specific 3D-models. Three patients(15%) had bilateral SCFE. Mean age was 13±2(10-16) years and 67% were male patients (86% unstable slip, 81% chronic slip). The contralateral hips of 15 patients with unilateral SCFE were evaluated(control group). Validated software was used for 3D impingement-simulation (equidistant-method). RESULTS: (1)Impingement-free flexion(46±32°) and IRF-90°(-17±18°) were significantly(p<0.001) decreased in untreated severe SCFE patients compared to contralateral side(122±9° and 36±11°). (2)Frequency of impingement was significantly(p<0.001) higher in 30° and 60° flexion (48% and 71%) of patients with severe SCFE compared to control group(0%). (3)Acetabular impingement conflict was located anterior-superior(SCFE patients), mostly 12 o'clock (50%) in IRF-90° (70% on 2 o'clock for maximal flexion). Femoral impingement was located on anterior-superior to anterior-inferior femoral metaphysis(between 2-6 o'clock, 40% on 3 o'clock and 40% on 5 o'clock) in IRF-90° and on anterior metaphysis(40% on 3 o'clock) in maximal flexion and frequency was significantly(p<0.001) different compared to control group. CONCLUSION: Severe SCFE patients have limited hip flexion and IR due to early hip impingement using patient-specific preoperative 3D-models. Due to the large variety of hip motion, individual evaluation is recommended to plan the osseous correction for severe SCFE patients.
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Personal name Kim, Young-Jo
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9 (RLIN) 3099
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Personal name Kiapour, Ata
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9 (RLIN) 3100
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Personal name Zwingelstein, Sébastien
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9 (RLIN) 3101
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Personal name Steppacher, Simon D.
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9 (RLIN) 3102
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Personal name Tannast, Moritz
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9 (RLIN) 3103
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Personal name Siebenrock, Klaus A.
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9 (RLIN) 3104
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Personal name Novais, Eduardo N.
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9 (RLIN) 3105
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Note J Pediatr Orthop
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Uniform Resource Identifier <a href="http://dx.doi.org/10.1097/BPO.0000000000002249">http://dx.doi.org/10.1097/BPO.0000000000002249</a>
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