Skip to main content
Top
Published in: Clinical Orthopaedics and Related Research® 8/2016

01-08-2016 | CORR Insights

CORR Insights®: Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?

Author: Douglas G. Armstrong, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 8/2016

Login to get access

Excerpt

Few conditions are guaranteed to generate controversy amongst pediatric orthopaedic surgeons as much as unstable slipped capital femoral epiphysis (SCFE). Loder [3] coined the term “unstable SCFE” in 1993, and defined it in clinical terms as a patient with a SCFE who is unable to weight bear, even with crutches. However, even that simple definition is not entirely agreed upon [3, 7, 8]. No published studies, individually or in systematic review, have been sufficiently powered to answer basic questions regarding unstable SCFE [8]. Among the questions: What should be the diagnostic criteria? What is the optimal timing for treatment? Which treatment is best? …
Literature
1.
go back to reference Dietz FR. Reflections on the failure of the POSNA-sponsored multicenter trial for treatment of unstable slipped capital femoral epiphysis. J Pediatr Orthop 2010;30:386–389.CrossRefPubMed Dietz FR. Reflections on the failure of the POSNA-sponsored multicenter trial for treatment of unstable slipped capital femoral epiphysis. J Pediatr Orthop 2010;30:386–389.CrossRefPubMed
2.
go back to reference Han S, Hoffman MD, Proctor AR, Vella JB, Mannoh EA, Barber NE, Kim HJ, Jung KW, Benoit DS, Choe R. Non-invasive monitoring of temporal and spatial blood flow during bone graft healing using diffuse correlation spectroscopy. PLoS One. 2015;10:e0143891.CrossRefPubMedPubMedCentral Han S, Hoffman MD, Proctor AR, Vella JB, Mannoh EA, Barber NE, Kim HJ, Jung KW, Benoit DS, Choe R. Non-invasive monitoring of temporal and spatial blood flow during bone graft healing using diffuse correlation spectroscopy. PLoS One. 2015;10:e0143891.CrossRefPubMedPubMedCentral
3.
go back to reference Loder RT. What is the cause of avascular necrosis in unstable slipped capital femoral epiphysis and what can be done to lower the rate? J Pediatr Orthop 2013;33 Suppl 1:S88–91.CrossRefPubMed Loder RT. What is the cause of avascular necrosis in unstable slipped capital femoral epiphysis and what can be done to lower the rate? J Pediatr Orthop 2013;33 Suppl 1:S88–91.CrossRefPubMed
4.
go back to reference Palocaren T, Holmes L, Rogers K, Kumar SJ. Outcome of in situ pinning in patients with unstable slipped capital femoral epiphysis: Assessment of risk factors associated with avascular necrosis. J Pediatr Orthop 2010;30:31–36.CrossRefPubMed Palocaren T, Holmes L, Rogers K, Kumar SJ. Outcome of in situ pinning in patients with unstable slipped capital femoral epiphysis: Assessment of risk factors associated with avascular necrosis. J Pediatr Orthop 2010;30:31–36.CrossRefPubMed
5.
go back to reference Phadnis J, Phillips P, Willoughby R. The epidemiologic characteristics of slipped capital femoral epiphysis in Maori children. J Pediatr Orthop 2012;32:510–514.CrossRefPubMed Phadnis J, Phillips P, Willoughby R. The epidemiologic characteristics of slipped capital femoral epiphysis in Maori children. J Pediatr Orthop 2012;32:510–514.CrossRefPubMed
6.
go back to reference Sankar WN, McPartland TG, Millis MB, Kim YJ. The unstable slipped capital femoral epiphysis: Risk factors for osteonecrosis. J Pediatr Orthop 2010;30:544–548.CrossRefPubMed Sankar WN, McPartland TG, Millis MB, Kim YJ. The unstable slipped capital femoral epiphysis: Risk factors for osteonecrosis. J Pediatr Orthop 2010;30:544–548.CrossRefPubMed
7.
go back to reference Wenger DR, Bomar JD. Acute, unstable, slipped capital femoral epiphysis: is there a role for in situ fixation? J Pediatr Orthop 2014;34 Suppl 1:S11–17.CrossRefPubMed Wenger DR, Bomar JD. Acute, unstable, slipped capital femoral epiphysis: is there a role for in situ fixation? J Pediatr Orthop 2014;34 Suppl 1:S11–17.CrossRefPubMed
8.
go back to reference Zaltz I, Baca G, Clohisy JC. Unstable SCFE: Review of treatment modalities and prevalence of osteonecrosis. Clin Orthop Relat Res 2013;471:2192–2198.CrossRefPubMedPubMedCentral Zaltz I, Baca G, Clohisy JC. Unstable SCFE: Review of treatment modalities and prevalence of osteonecrosis. Clin Orthop Relat Res 2013;471:2192–2198.CrossRefPubMedPubMedCentral
Metadata
Title
CORR Insights®: Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?
Author
Douglas G. Armstrong, MD
Publication date
01-08-2016
Publisher
Springer US
Published in
Clinical Orthopaedics and Related Research® / Issue 8/2016
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-016-4869-1

Other articles of this Issue 8/2016

Clinical Orthopaedics and Related Research® 8/2016 Go to the issue