Cazzulino A, Wu W, Allahabadi S, Swarup I. Diagnosis and Management of Unstable Slipped Capital Femoral Epiphysis: A Critical Analysis Review.
JBJS Rev 2021;
9:01874474-202107000-00007. [PMID:
34270502 DOI:
10.2106/jbjs.rvw.20.00268]
[Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
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An unstable slipped capital femoral epiphysis (SCFE) is characterized by the inability to walk and is associated with a high risk of osteonecrosis.
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An unstable SCFE is less common than a stable SCFE; however, the demographics are similar in both groups of patients with SCFE.
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The diagnosis of an unstable SCFE is characterized by a history of antecedent pain and the inability to walk on examination, and it is confirmed by radiographic assessment.
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Management of an unstable SCFE includes closed reduction, open reduction, and capital realignment, which have all been noted to have lower rates of osteonecrosis than reported in historic reports.
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All management approaches have certain advantages and disadvantages, and comparative studies are needed to guide clinical decision-making.
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