Severity of Asynchronous Slipped Capital Femoral Epiphyses in Skeletally Immature Versus More Skeletally Mature Patients

Nowicki, Philip D.; Silva, Selina; Toelle, Lisa J.; Strohmeyer, Greg; Wahlquist, Trevor C.; Y, Li; Farley, Frances A.; Caird, Michelle S.

doi:10.1097/bpo.0000000000000678

Cited by 6 publications

(2 citation statements)

References 22 publications

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“…Information regarding the status of the tri-radiate physis in SCFE patients has been primarily used when considering prophylactic fixation of the opposite hip when a patient with a unilateral SCFE presents. Popejoy et al [ 36 ] were instrumental in pointing this out, and the literature regarding the status of the tri-radiate physis in SCFE patients seems to concentrate solely on the consideration for prophylactic fixation of the opposite hip [ 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 ]. Our findings that the status of the tri-radiate physis in SCFE patients is also correlated with SCFE severity (LESA) is likely new and needs further corroboration from other centers.…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Slipped Capital Femoral Epiphysis: Demographic Differences and Similarities between Stable, Unstable, and Valgus Types

Loder,

Gunderson,

Sun

2023

Children

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Idiopathic slipped capital femoral epiphysis (SCFE) is a known disorder in pre/adolescent children with vague hip/knee pain. We wished to study the demographic differences between stable varus, unstable varus, and valgus idiopathic SCFEs using a retrospective review over a 10-year period of SCFE children seen at a tertiary children’s hospital. Standard demographic data was collected, and radiographs were measured to determine the Southwick angle and status of the tri-radiate cartilage. There were 190 patients; 138 had stable varus SCFEs, 45 unstable varus SCFEs, and 7 valgus SCFEs. All unstable SCFEs were varus, and all valgus SCFEs were stable. There were significant differences between the three groups by age at diagnosis, sex, race, SCFE severity, weight percentile, and duration of symptoms. The average age at diagnosis was 11.0 ± 1.2, 11.8 ± 1.8, and 12.3 ± 1.7 years for the valgus, unstable varus, and stable varus groups (p = 0.019), and similarly, SCFE severity was 25° ± 15°, 48° ± 18°, and 35° ± 19° (p = 0.0002) for the three same groups. Patients with valgus SCFEs were mostly female (86%) compared to the stable varus (39.9%) and unstable (47%) groups (p = 0.05) and mostly non-White (86%) (0.011). The duration of symptoms was 4.1 ± 4.1, 2.3 ± 5.0, and 4.5 ± 5.0 months for the valgus, unstable varus, and stable varus groups (p = 0.00005). These three types of idiopathic SCFEs demonstrated differences by age at diagnosis, sex, race, weight percentile, and duration of symptoms.

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Section: Discussionmentioning

confidence: 99%

Idiopathic Slipped Capital Femoral Epiphysis: Demographic Differences and Similarities between Stable, Unstable, and Valgus Types

Loder,

Gunderson,

Sun

2023

Children

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“…We note that, for the 70 children with a bilateral SCFE (27 had bilateral SCFE at the initial presentation), only one child developed a severe and unstable SCFE in the other hip (one of the 43 sequential hips with SCFE); this rate is similar to that in some reports 51 , 57 but contrasts with that of other reports. 6 , 58 – 60 A regular follow-up schedule, with repeated radiographs together with repeated and thorough information given to the family about the necessity for an urgent radiographic examination whenever symptoms occur in the contralateral hip, might explain the difference between reports.…”

Section: Discussionmentioning

confidence: 99%

Outcomes after slipped capital femoral epiphysis: A population-based study with three-year follow-up

Herngren

Stenmarker

Enskär

et al. 2018

Journal of Children's Orthopaedics

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Abstract:PurposeTo evaluate outcomes three years after treatment for slipped capital femoral epiphysis (SCFE): development of avascular necrosis (AVN), subsequent surgery, hip function and the contralateral hip.MethodsThis prospective cohort study included a total national population of 379 children treated for SCFE between 2007 and 2013. A total of 449 hips treated for SCFE and 151 hips treated with a prophylactic fixation were identified. The Barnhöft questionnaire, a valid patient-reported outcome measure (PROM), was used.ResultsIn all, 90 hips had a severe slip, 61 of these were clinically unstable. AVN developed in 25 of the 449 hips. Six of 15 hips treated with capital realignment developed AVN. A peri-implant femur fracture occurred in three slipped hips and in two prophylactically pinned hips. In three of these five hips technical difficulties during surgery was identified. In 43 of 201 hips scheduled for regular follow-up a subsequent SCFE developed in the contralateral hip. Implant extraction after physeal closure was performed in 156 of 449 hips treated for SCFE and in 51 of 151 prophylactically fixed hips. Children with impaired hip function could be identified using the Barnhöft questionnaire.ConclusionFixation in situ is justified to remain as the primary treatment of choice in SCFE. Overweight is more common in children with SCFE than in the average population. Prophylactic fixation is a safe procedure when performed using a correct technique. The number of patients who developed AVN after capital realignment is of concern. We recommend rigorous follow-up of both hips, including PROM evaluation, until physeal closure.Level of EvidenceII - prospective cohort study

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Novelties in slipped capital femoral epiphysis imaging: A narrative review

De Angelis,

Aparisi Gomez,

Negro

et al. 2024

Heliyon

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Severity of Asynchronous Slipped Capital Femoral Epiphyses in Skeletally Immature Versus More Skeletally Mature Patients

Abstract: Level III-retrospective comparative study.

Cited by 6 publications

References 22 publications

Idiopathic Slipped Capital Femoral Epiphysis: Demographic Differences and Similarities between Stable, Unstable, and Valgus Types

Idiopathic Slipped Capital Femoral Epiphysis: Demographic Differences and Similarities between Stable, Unstable, and Valgus Types

Outcomes after slipped capital femoral epiphysis: A population-based study with three-year follow-up

Novelties in slipped capital femoral epiphysis imaging: A narrative review

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