Management Outcome and the Role of Manipulation in Slipped Capital Femoral Epiphysis

Autor: YJ Lim, KS Lam, KBL Lim, A Mahadev, EH Lee
Jazyk: angličtina
Rok vydání: 2007
Předmět:
Zdroj: Journal of Orthopaedic Surgery, Vol 15 (2007)
Druh dokumentu: article
ISSN: 2309-4990
23094990
DOI: 10.1177/230949900701500319
Popis: Purpose. To examine and compare treatment outcomes for slipped capital femoral epiphysis (SCFE). Methods. 24 patients with acute or acute-on-chronic SCFE underwent preoperative traction, 13 of them followed by in situ screw fixation (group A), and the remaining 11, manipulation with screw fixation (group B). Their treatment outcomes (according to the Aadalen criteria) and complications were compared. Results. There were 2 treatment failures and one poor outcome in patients with acute SCFE (2 had avascular necrosis and one had slight pain with mild limitation of hip movement). The risk of developing avascular necrosis was significantly higher in patients with acute rather than acute-on-chronic or chronic slips. No significant differences were evident between groups A and B with regard to age, sex, ethnicity, outcomes, and preoperative and postoperative changes in the Southwick headshaft angle. Conclusion. Patients with acute or acute-on-chronic SCFE can be safely managed with straight-leg traction for up to 6 days, followed by in situ screw fixation without manipulation. Manipulation is not recommended in such slips, due to a higher avascular necrosis risk.
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