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Clinical Orthopaedics and Related Research®

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01-07-2013 | Symposium: Slipped Capital Femoral Epiphysis: Update and Emerging Concepts

Unstable SCFE: Review of Treatment Modalities and Prevalence of Osteonecrosis

Authors: Ira Zaltz, MD, Geneva Baca, PhD, John C. Clohisy, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 7/2013

Abstract

Background

The treatment of unstable slipped capital femoral epiphysis (SCFE) is rapidly evolving with the ability to correct epiphyseal alignment using the modified Dunn technique. Adopting a new treatment method depends on confirming that it achieves its goals, produces few, nonserious complications with no lasting sequelae, and improves the natural history of the disorder compared with known treatment methods. As such, the rates of osteonecrosis and complications after current treatments of unstable SCFE must be compared with those of newer surgical techniques.

Questions/purposes

We therefore addressed the following questions: (1) What is the rate of osteonecrosis of the femoral head after treatment of unstable SCFE? (2) What treatment modalities have been used for unstable SCFE and (3) what are the reported complications?

Methods

We performed a systematic electronic literature search for the keywords unstable and slipped capital femoral epiphysis and identified 199 articles. Of these, 60 met our inclusion criteria. Fifteen articles were included for analysis.

Results

The literature concerning the treatment and results of unstable SCFE is retrospective Level IV data that suggest an overall rate of osteonecrosis of 23.9%. Multiple treatment modalities were used for unstable SCFE treatment with varying, inconsistently recorded complications over the reporting period.

Conclusions

We found limited data concerning the rate of osteonecrosis and complications after treatment of unstable SCFE. Considering recent widespread interest in the modified Dunn procedure and the possibility of iatrogenic osteonecrosis, there is a need for prospective studies to identify complications and establish outcome based on standardized scores for established and emerging treatments of unstable SCFE.

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Title: Unstable SCFE: Review of Treatment Modalities and Prevalence of Osteonecrosis
Authors: Ira Zaltz, MD
Geneva Baca, PhD
John C. Clohisy, MD
Publication date: 01-07-2013
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 7/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-012-2765-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Unstable SCFE: Review of Treatment Modalities and Prevalence of Osteonecrosis

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

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