AI Article Synopsis
- Management of unstable slipped capital femoral epiphysis (SCFE) is debated due to high risks of avascular necrosis (AVN).
- A study involved 28 patients with 30 unstable SCFE cases who received urgent treatment using two 6.5-mm cannulated screws, with most procedures involving positional reduction.
- Follow-up after an average of 5.5 years showed low rates of complications, with only four patients developing AVN and some reporting limp or groin pain, indicating the treatment's effectiveness in reducing serious risks.
Article 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).
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| http://dx.doi.org/10.1097/BPO.0b013e3181b7687a | DOI Listing |
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