Slipped femoral epiphysis in a teenager: a cause of cam defo
16-year boy reported with pain and limping gait. No history of trauma. Clinical examination revealed a Drehmann sign on the left hip. The opposite right hip has full and normal function. No illnesses were known. X-ray investigation of the pelvis and axial view showed a slipped femoral epiphysis backwards of 20° on the left hip (Figure 1).

Various surgical options were discussed which the parents. The boy was treated through in sitú fixation of the left slipped epiphysis with 2 large titanium screws. A prophylactic fixation on the right hip was done by one screw (Figures 2 & 3). No complications were seen postoperatively. The removal of the screws was proposed at the closure of the growth plates.

2 years after surgery the boy developed a cam deformity and impingement, both on the left and on the right hip: he complained pain with forced flexion and internal rotation of the hips. The x-ray revealed a cam deformity on the right and left hip. The authors corrected first the cam deformity on the right site, successively on the left site.

Removal of screws wasn’t done simultaneously with the neck trimming because the titanium screws had to be removed by over drilling. The postoperative rehabilitation was without problems. The boy reached complete function of the right and left hip without impingement symptoms.

Read more here: https://juniperpublishers.com/oroaj/pdf/OROAJ.MS.ID.555837.pdf
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