Early reduction, arthrotomy, and cannulated screw fixation in unstable slipped capital femoral epiphysis treatment

J. Eric Gordon, Matthew S. Abrahams, Matthew B. Dobbs, Scott J. Luhmann, Perry L. Schoenecker

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Sixteen consecutive cases of unstable slipped capital femoral epiphysis treated with urgent reduction and pinning during a 7-year period are presented. In 2 of the 16 patients, avascular necrosis of the femoral head developed. Ten of the 16 patients were treated within 24 hours after the onset of acute symptoms by reduction, arthrotomy, and cannulated screw fixation of the hip using two screws. In none of these patients did avascular necrosis of the femoral head develop. Two patients required hardware removal for persistent pain, and one required a revision pinning after a nondisplaced femoral neck fracture. Chondrolysis did not develop in any patient, and no hip progressed after fixation. At last follow-up (mean 27 months after surgery), two patients walked with a moderate limp. Three reported persistent mild pain in the affected hip. Early reduction of unstable hips with arthrotomy and pinning using two cannulated screws to minimize the risk of avascular necrosis is recommended.

Original languageEnglish
Pages (from-to)352-358
Number of pages7
JournalJournal of Pediatric Orthopaedics
Volume22
Issue number3
DOIs
StatePublished - Jan 1 2002

Keywords

  • Avascular necrosis
  • Hip
  • Reduction
  • Slipped capital femoral epiphysis
  • Unstable

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