Demographic Predictors of Severity of Stable Slipped Capital Femoral Epiphyses

Loder, Randall T.; Starnes, Trevor; Dikos, Greg; Aronsson, David D.

doi:10.2106/jbjs.e.00069

Cited by 29 publications

(33 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In 2482 children, the average symptom duration was 4.3 months; 4.5 months for boys and 3.6 months for girls (Table 4). Two recent studies have noted a decrease in symptom duration to 2-3 months [46, 88]. …”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

The Epidemiology and Demographics of Slipped Capital Femoral Epiphysis

2011

Self Cite

View full text Add to dashboard Cite

The etiology of slipped capital femoral epiphysis (SCFE) is unknown with many insights coming from epidemiologic/demographic information. A systematic medical literature review regarding SCFE was performed. The incidence is 0.33/100,000 to 24.58/100,000 children 8 to 15 years of age. The relative racial frequency, relative to Caucasians at 1.0, is 5.6 for Polynesians, 3.9 for Blacks, and 2.5 for Hispanics. The average age is 12.0 years for boys and 11.2 years for girls. The physiologic age when SCFE occurs is less variable than the chronologic age. The average symptom duration is 4 to 5 months. Most children are obese: >50% are >95th percentile weight for age with average BMI is 25–30 kg/m2. The onset of SCFE is in the summer when north of 40°N. Bilaterality ranges from 18 to 50%. In children with bilateral involvement, 50–60% present with simultaneous SCFEs and those who present with a unilateral SCFE and subsequently develop a contralateral SCFE do so within 18 months. The age at presentation is younger for those who present with a unilateral SCFE and later develop a contralateral SCFE. The age-weight, age-height, and height test are useful to differentiate between an idiopathic and atypical SCFE.

show abstract

Section: Resultsmentioning

confidence: 99%

“…Although there is a general correlation between symptom duration and SCFE severity [88] there is considerable variability (Figure 6(a)) [46]. For any given individual child, slip severity and symptom duration is unique; in a large population, there is a weak positive correlation with slip severity and symptom duration.…”

Section: Resultsmentioning

confidence: 99%

The Epidemiology and Demographics of Slipped Capital Femoral Epiphysis

2011

Self Cite

View full text Add to dashboard Cite

show abstract

“…The main predictive factors for degree of stable SCFE are age at diagnosis and symptom duration [36,51]. The most worrisome complication of treatment is AVN of the femoral head, which is strongly associated with SCFE instability [50,65,66,84].…”

Section: Search Strategies and Criteriamentioning

confidence: 99%

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Novais

Millis

2012

Clinical Orthopaedics &Amp; Related Research

136

View full text Add to dashboard Cite

Background Obesity is a risk factor for developing slipped capital femoral epiphysis (SCFE). The long-term outcome after SCFE treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis (AVN). Femoroacetabular impingement (FAI) is associated with SCFE-related deformity and dysfunction in both short and long term. Questions/Purposes We examined obesity prevention, early diagnosis, reducing AVN and hip deformity as strategies to reduce SCFE prevalence, and the long-term outcomes after treatment. Methods A search of the literature using the PubMed database for the key concepts SCFE and treatment, natural history, obesity, and prevalence identified 218, 15, 26, and 49 abstracts, respectively. Where Are We Now? A correlation between rising childhood obesity and increasing incidence of SCFE has been recently reported. Residual abnormal morphology of the proximal femur is currently believed to be the mechanical cause of FAI and early articular cartilage damage in SCFE. Where Do We Need to Go? Reducing the increasing prevalence rate of SCFE is important. Treatment of SCFE should aim to reduce AVN rates and residual deformities that lead to FAI to improve the long-term functional and clinical outcomes. How Do We Get There? Implementing public health policies to reduce childhood obesity should allow for SCFE prevalence to drop. Clinical trials will evaluate whether restoring the femoral head-neck offset to avoid FAI along with SCFE fixation allows for cartilage damage prevention and lower rates of osteoarthritis. The recently described surgical hip dislocation approach is a promising technique that allows anatomic reduction with potential lower AVN rates in the treatment of SCFE.

show abstract

“…Once a diagnosis is made, treatment is indicated to prevent slip progression and to avoid complication, especially osteonecrosis and chondrolysis [6,9,10].…”

Section: Discussionmentioning

confidence: 99%

Complications and associated risk factors at screw removal in slipped capital femoral epiphysis treated by cannulated stainless steel screws

Pretell-Mazzini

Rodríguez-Vega

Muñoz-Ledesma

et al. 2012

Journal of Children's Orthopaedics

View full text Add to dashboard Cite

Purpose The aim of our study is to report our complication rate and analyze the associated risk factors when removing cannulated stainless steel screws for SCFE fixation. Methods This was a multicenter retrospective study of patients who underwent removal of cannulated stainless steel screws after a mean time of 2.03 years of implantation. Thirty-two patients were included (38 hips) with a mean of 13.7 years of age during screw removal surgery.The mean post-removal follow up time was 1.6 years. In all cases the removal of screws was done systematically. Demographic data, possible risk factors related to removal failure, as well as post-removal complications such as postremoval fractures, infections and scar issues were recorded. Results A removal failure rate of 15.79 % (6/38) was found. The removal surgical time was longer than the initial fixation time but without statistical significance (70.78 vs 61.84 m, p = 0.196). However, the duration of screw implantation (r 2 : 7.09; IC: 1.12-13.06) and screw head bony coverage (r 2 : 21.32; IC: 5.58-37.06) were both related to this prolonged time. Multivariant analysis revealed that a fully threaded cannulated screw had the lowest removal failure risk (OR: 0.3; IC: 0.14-0.61). There were no postremoval complications recorded. Conclusions We recommend to use full threaded cannulated stainless steel screws and to perform the procedure as soon as the physis are closed to decrease the surgical time. It is a safe procedure based on a low rate of complications such as post-removal fractures, infection and scar issues.

show abstract

Demographic Predictors of Severity of Stable Slipped Capital Femoral Epiphyses

Cited by 29 publications

References 28 publications

The Epidemiology and Demographics of Slipped Capital Femoral Epiphysis

The Epidemiology and Demographics of Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis: Prevalence, Pathogenesis, and Natural History

Complications and associated risk factors at screw removal in slipped capital femoral epiphysis treated by cannulated stainless steel screws

Contact Info

Product

Resources

About