case_images: PMC11005756_01
case_images: Pre-operative pelvic and hip radiographs of Patient A and B. (A) Anteroposterior radiograph of the pelvis showing chronic slipped capital femoral epiphysis of the left hip of Patient A. (B) Frog-leg lateral radiograph of the left hip of Patient A. (C) Anteroposterior radiograph of the pelvis showing chronic slipped capital femoral epiphysis of the left hip of Patient B. (D) Frog-leg lateral radiograph of the left hip of Patient B.
case_images: hnad042f1.jpg
case_images: PMC11005756_02_hnad042f1.jpg
case_images: F1
case_images: Radiographs showed a closed and healed proximal femur physis with deformities consisting of coxa vara, coxa breva, epiphyseal retroversion, femoral extension and a cam lesion (Fig. 1C and D).
case_images: PMC11005756_02
case_images: Pre-operative pelvic and hip radiographs of Patient A and B. (A) Anteroposterior radiograph of the pelvis showing chronic slipped capital femoral epiphysis of the left hip of Patient A. (B) Frog-leg lateral radiograph of the left hip of Patient A. (C) Anteroposterior radiograph of the pelvis showing chronic slipped capital femoral epiphysis of the left hip of Patient B. (D) Frog-leg lateral radiograph of the left hip of Patient B.
case_images: hnad042f1.jpg
case_images: PMC11005756_02_hnad042f1.jpg
case_images: F1
case_images: Radiographs showed a closed and healed proximal femur physis with deformities consisting of coxa vara, coxa breva, epiphyseal retroversion, femoral extension and a cam lesion (Fig. 1C and D).
case_images: Three-dimensionally printed models obtained from a patient with chronic slipped capital femoral epiphysis deformity of the hip joint. (A) Anterior view of hip and pelvis model showing the external rotation, varus and anterior displacement of the proximal femur metaphysis relative to the epiphysis. (B) Anterior view of proximal femur model without the acetabulum and pelvis for better visualization of the proximal femur deformity. (C) Posterior view of hip and pelvis model demonstrating the displaced relationship between the proximal femur metaphysis and epiphysis. (D) Posterior view of proximal femur without the acetabulum and hemipelvis for better visualization of the proximal femur deformity.
case_images: hnad042f2.jpg
case_images: PMC11005756_02_hnad042f2.jpg
case_images: F2
case_images: CT scan of a patient with chronic SCFE deformity (Fig. 2). CT scan was obtained from the Hospital Medical Imaging Department server as an anonymized digital imaging and communications in medicine (DICOM) file.
case_images: Three-dimensionally printed models of planned osteotomy cuts and deformity correction. (A) Anterior view of the model showing the proposed osteotomy cuts and the deformity correction. Osteotomy cuts parallel to the superior and inferior border of the femoral neck dividing the proximal femur into the greater trochanter (GT), the neck (N) and the shaft (S) segments. Deformity correction in the coronal plane consisted of valgus correction of the femoral neck-shaft angle, internal rotation and lateralization of the femoral shaft, and distalisation of the greater trochanter. (B) Lateral view of the osteotomized model showing corrections in the sagittal plane which consisted of internal rotation of the femoral shaft.
case_images: hnad042f3.jpg
case_images: PMC11005756_02_hnad042f3.jpg
case_images: F3
case_images: Intraoperative fluoroscopic image of Patient B showing arthroscopic osteochondroplasty and removal of the bony protrusion at the anterosuperior metaphyseal-epiphysial junction prior to McMaster Osteotomy.  90  arthroscopic camera, *Arthroscopic burr; A, acetabulum; H, femoral head; N, femoral neck; GT, greater trochanter; LT, lesser trochanter.
case_images: hnad042f4.jpg
case_images: PMC11005756_02_hnad042f4.jpg
case_images: F4
case_images: Osteochondroplasty was performed with intraoperative fluoroscopy to decompress the head and neck junction and partially restore the offset and concavity (Fig. 4).
case_images: Intra-operative fluoroscopic images patient B undergoing left hip McMaster osteotomy. (A) K-wires making out the centre of the femoral neck (*), and planned locations for osteotomy at the greater trochanter (1), superior border of the femoral neck (2), and inferior border of the femoral neck (3). (B) Post-osteotomy, the proximal femur divided into the greater trochanter (GT), graft (G), neck (N) and shaft (S) segments. Osteotomy fixation with proximal femur locking plate showing the incorporation of the graft to the lateral cortex of the neck segment for femoral neck lengthening. The distal shaft segment is then reduced to the neck with the plate in flexion, internal rotation and abduction to restore the neck-shaft angle and proper alignment of the proximal femur. (C) The greater trochanter segment is distalized to the appropriate position with a large pointed reduction clamp prior to fixation. (D) The greater trochanter is fixated in the distalized position with two 4.5 mm cannulated screws with washers.
case_images: hnad042f5.jpg
case_images: PMC11005756_02_hnad042f5.jpg
case_images: F5
case_images: Three parallel K-wires were then inserted, two wires marking out the superior and inferior borders of the femoral neck, and the third wire through the centre of the GT (Fig. 5A). The bone graft, along with the plate, was then fixed proximally onto the lateral cortex of the neck with three 5 mm locking screws, thus achieving the desired neck lengthening (Fig. 5B). In addition, the varus and extension deformities were corrected as the distal femoral shaft was reduced onto the plate (Fig. 5C). The GT segment was fixated using two 4.5 mm cannulated screws with washers (Fig. 5D).