Urgent reduction, fixation, and arthrotomy for unstable slipped capital femoral epiphysis

Ryan C. Chen, Perry L. Schoenecker, Matthew B. Dobbs, Scott J. Luhmann, Deborah A. Szymanski, J. Eric Gordon

Research output: Contribution to journalArticlepeer-review

36 Scopus citations

Abstract

BACKGROUND: The management of unstable slipped capital femoral epiphysis (SCFE) is controversial. A high incidence of avascular necrosis (AVN) has been reported after unstable SCFE. METHODS: Twenty-eight consecutive patients with thirty unstable SCFE underwent urgent reduction and fixation with two 6.5-mm cannulated screws. Positional reduction was performed in 25 cases. Arthrotomy was performed percutaneously in 16 cases and as part of an open capsulotomy in 5 cases. RESULTS: Slip severity was mild in 13 patients, moderate in 9, and severe in 8. At mean duration of follow-up of 5.5 years (range: 2.0 to 11.2), 4 patients reported groin pain, and 8 patients reported a limp. Four patients developed AVN. One patient experienced slip progression and no patient developed chondrolysis. CONCLUSIONS: Treatment of unstable SCFE with urgent positional reduction with accompanying arthrotomy and fixation through 2 cannulated screws resulted in a low incidence of slip progression and AVN. LEVEL OF EVIDENCE: Therapeutic study, level 4 (case series, no or historical control group).

Original languageEnglish
Pages (from-to)687-694
Number of pages8
JournalJournal of Pediatric Orthopaedics
Volume29
Issue number7
DOIs
StatePublished - Oct 1 2009

Keywords

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

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