Treatment of Proximal Femoral Epiphysiolysis with Subtrochanteric Osteotomy by the Ilizarov Method

OBJECTIVES To evaluate the treatment of severe proximal femoral epiphysiolysis through subtrochanteric osteotomy using the Ilizarov method and to propose a new method for calculating the necessary correction. METHODS A case study was carried out among patients affected by severe proximal femoral epiphysiolysis who underwent subtrochanteric osteotomy with external multiplanar fixation and were evaluated postoperatively using the modified Southwick classification. A method was developed for calculating the angular correction needed for the surgical procedure. RESULTS Thirteen hips were analyzed: four left hips (30.8%) and nine right hips (69.2%). The majority of the patients (61.5%) were male, with a mean age of 14 years. In relation to pain and function, the results were excellent for 30.8%, good for 46.2% and regular for 23.0%, and none of the patients presented poor results. Regarding mobility, the results were excellent for 46.2%, good for 30.8% and regular for 23.0%. Radiographically, the results were excellent for 7.7%, good for 69.2%, regular for 15.4% and poor for 7.7%. CONCLUSIONS Percutaneous treatment of severe proximal epiphysiolysis using the Ilizarov method is a good treatment option with good indices for improvement of pain and function. The proposed calculation method can help in planning surgical procedures, with variations between calculated and measured angles of the order of 3°.