Eur J Pediatr Surg 2011; 21(2): 131-134
DOI: 10.1055/s-0030-1262792
Case Gallery

© Georg Thieme Verlag KG Stuttgart · New York

Slippage of the Proximal Femoral Epiphysis Related to Multiple Enchondromatosis: Treatment with Staged Surgical Dislocation and Epiphyseal Realignement. A Case Report at Seven Years Follow up

T. Slongo1 , P. P. Schmittenbecher2 , R. Ganz3
  • 1University of Berne, Inselspital, Pediatric Surgery, Berne, Switzerland
  • 2Municipal Hospital, Department of Pediatric Surgery, Karlsruhe, Germany
  • 3University of Berne, Inselspital, Department of Orthopedics, Berne, Switzerland
Further Information

Publication History

Publication Date:
18 October 2010 (online)

Introduction

Multiple enchondromatosis (Ollier's disease) is characterized by metaphyseal cartilaginous lesions usually restricted to one side of the body. The lower extremity is more commonly involved. Enchondromas can lead to growth disturbance, deformity and pathological fractures [1] [2] [3]. Involvement of the femoral neck has been mentioned in 1 veterinary report and 3 human case reports [4] [5]. Retrotilt of the proximal femoral epiphysis as a result of a femoral neck enchondroma leading to femoro-acetabular impingement has not been presented to date.

References

  • 1 Schwarz W, Hardes J, Schulte M. [Multiple enchondromatosis: Ollier's disease].  Unfallchirurg. 2002;  105 1139-1142
  • 2 Shapiro F. Ollier's Disease. An assessment of angular deformity, shortening, and pathological fracture in 21 patients.  J Bone Joint Surg A. 1982;  64 95-103
  • 3 Silve C, Jüppner H. Ollier disease.  Orphanet J Rare Dis. 2006;  1 37
  • 4 Matis U, Krauser K, Schwartz-Porsche D. et al . [The clinical picture of multiple enchondromatosis in the dog].  Tierärztl Prax. 1990;  18 192-199
  • 5 Wenger DR, Birch J, Rathjen K. et al . Metachondromatosis and avascular necrosis of the femoral head: a radiographic and histologic correlation.  J Pediatr Orthop. 1991;  11 294-300
  • 6 Ganz R, Huff TW, Leunig M. Extended retinacular soft-tissue flap for intra-articular hip surgery: surgical technique, indications, and results of application.  Instr Course Lect. 2009;  58 241-255
  • 7 Ganz R, Gill T, Gautier E. et al . Surgical dislocation of the adult hip: a technique with full access to the femoral head and acetabulum without the risk of avascular necrosis.  J Bone Joint Surg Br. 2001;  83 1119-1124
  • 8 Leunig M, Slongo T, Kleinschmidt M. et al . Subcapital correction osteotomy in slipped capital femoral epiphysis by means of surgical hip dislocation.  Orthop Traumatol. 2007;  19 389-410
  • 9 Jesus-Garcia R, Bongiovanni JC, Korukian M. et al . Use of the Ilizarov external fixator in the treatment of patients with Ollier's disease.  Clin Orthop Relat Res. 2001;  382 82-86
  • 10 Watanabe K, Tsuchiya H, Sakurakichi K. et al . Treatment of lower limb deformities and limb-length discrepancies with the external fixator in Ollier's disease.  J Orthop Sci. 2007;  12 471-475
  • 11 Ganz R, Parvizi J, Beck M. et al . Femoroacetabular impingement: a cause for osteoarthritis of the hip.  Clin Orthop Relat Res. 2003;  417 112-120
  • 12 Leunig M, Casillas MM, Hamlet M. et al . Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis.  Acta Orthop Scand. 2000;  71 370-375
  • 13 Wenger DR, Kishan S, Pring ME. Impingement and childhood hip disease.  J Pediatr Orthop B. 2006;  15 233-243
  • 14 Exner GU, Schai PA, Nötzli HP. Treatment of acute slips and clinical results in slipped capital femoral epiphysis.  Orthopäde. 2002;  31 857-865
  • 15 Schai PA, Exner GU. Corrective Imhäuser intertrochanteric osteotomy.  Orthop Traumatol. 2007;  19 368-388
  • 16 Gautier E, Ganz K, Krugel N. et al . Anatomy of the medial femoral circumflex artery and its surgical implications.  J Bone Joint Surg Br. 2000;  82 679-683

Correspondence

Prof. Peter P. Schmittenbecher

Municipal Hospital

Department of Pediatric Surgery

Moltkestraße 90

76133 Karlsruhe

Germany

Phone: +49/0721/ 9743 101

Fax: +49/0721/ 9743 109

Email: Peter.Schmittenbecher@klinikum-karlsruhe.de