TY - JOUR
T1 - High-grade SCFE
T2 - The role of surgical hip dislocation and reduction
AU - Sucato, Daniel J.
AU - De La Rocha, Adriana
N1 - Publisher Copyright:
Copyright © 2014 by Lippincott Williams & Wilkins.
PY - 2014
Y1 - 2014
N2 - The patient with an unstable slipped capital femoral epiphsyis poses a challenging problem to the treating physician to improve the position of the displaced epiphysis to avoid femoroacetabular impingement without developing avascular necrosis (AVN)-a potentially devastating complication. Although the standard operative procedure of in situ pinning following an incidental reduction while positioning the patient on the table, has been the mainstay of treatment in North America, other viable options are available including a surgical dislocation approach to the hip followed by a modified Dunn osteotomy with control of the retinacular vessels, reduction of the epiphysis, and internal fixation with pins or screws. Although technically demanding, this approach offers an opportunity to reduce the epiphysis to avoid femoroacetabular impingement, and limit the possibility for the development of AVN. The early results for this procedure are promising with all studies demonstrating excellent reduction of the epiphysis and an overall lower incidence of AVN when compared with in situ pinning.
AB - The patient with an unstable slipped capital femoral epiphsyis poses a challenging problem to the treating physician to improve the position of the displaced epiphysis to avoid femoroacetabular impingement without developing avascular necrosis (AVN)-a potentially devastating complication. Although the standard operative procedure of in situ pinning following an incidental reduction while positioning the patient on the table, has been the mainstay of treatment in North America, other viable options are available including a surgical dislocation approach to the hip followed by a modified Dunn osteotomy with control of the retinacular vessels, reduction of the epiphysis, and internal fixation with pins or screws. Although technically demanding, this approach offers an opportunity to reduce the epiphysis to avoid femoroacetabular impingement, and limit the possibility for the development of AVN. The early results for this procedure are promising with all studies demonstrating excellent reduction of the epiphysis and an overall lower incidence of AVN when compared with in situ pinning.
KW - Avascular necrosis
KW - Slipped capital femoral epiphysis
KW - Surgical hip dislocation
KW - Unstable
UR - http://www.scopus.com/inward/record.url?scp=84913546254&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84913546254&partnerID=8YFLogxK
U2 - 10.1097/BPO.0000000000000297
DO - 10.1097/BPO.0000000000000297
M3 - Article
C2 - 25207732
AN - SCOPUS:84913546254
SN - 0271-6798
VL - 34
SP - S18-S24
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
ER -