The Kids' Inpatient Database, reflecting 6.70 million pediatric discharges in 1997 and 7.30 million in 2000, was coupled with the US Census Bureau data and was used to elicit the epidemiology of idiopathic slipped capital femoral epiphysis (SCFE) that occurred in children 9-16 years. It was found that the overall incidence of SCFE in the United States for these years was 10.80 cases/100,000 children. The relative incidence of SCFE was 3.94 times higher in black children and 2.53 times higher in Hispanic children than in white children. The incidence rate was significantly higher in boys (13.35 cases/100,000 children) than in girls (8.07 cases/100,000 children). Higher incidence rates of SCFE were found in the Northeast and West when compared with rates in the Midwest and the South, suggesting that climate plays a role in the onset of SCFE. Increased incidence of SCFE was noted north of 40 degrees latitude during the summer and south of 40 degrees latitude during the winter. Age of onset was also lower than previously reported and seems to be on a downward trend. This study suggests that the relative incidences of SCFE in blacks and Hispanics are higher than previously reported in the United States. Geographic, racial, and seasonal variations suggest that both environmental and genetic factors may influence the development of SCFE.

Children insured with Medicaid have limited access to orthopedic care in this nationwide sample. Medicaid physician reimbursement significantly correlates with patient access to medical care. These data may be of value in the ongoing efforts to improve access to medical care for children on Medicaid. The logical inference from this study is that increasing physician reimbursement rates will improve access. In the authors' opinion, reimbursement rates should be made higher than office overhead to effect meaningful change.

Background The Bernese periacetabular osteotomy (PAO) can relieve pain and restore function in patients with symptomatic acetabular dysplasia. Accurate acetabular correction is fundamental to achieving these clinical goals and presumably enhancing survivorship of the reconstruction. Fluoroscopy is used by some surgeons to assess intraoperative acetabular correction but it is unclear whether the features observed by fluoroscopy accurately reflect those on postoperative radiographs. Questions/Purposes We therefore determined whether the parameters of acetabular correction of PAO correlated on intraoperative fluoroscopic imaging and postoperative radiography. Conclusions Intraoperative fluoroscopic assessment of PAO correction correlated with that from the postoperative radiographic assessment. Measurement of lateral centeredge angle shows the highest correlation with the fewest outliers. Acetabular inclination and anterior center-edge angle also correlated; extrusion index and medial offset distance should be used with more caution.

Nepple, Jeffrey J.; Lehmann, Charles L.; Ross, James R.; Schoenecker, Perry L.; and Clohisy, John C., ,"Coxa profunda is not a useful radiographic parameter for diagnosing pincer-type femoroacetabular impingement

Level III, this was a retrospective comparative study.