Médecine

Paramédical

Autres domaines


S'abonner

Severe slipped capital femoral epiphysis: A French multicenter study of 186 cases performed by the SoFOP - 08/10/15

Doi : 10.1016/j.otsr.2015.04.005 
S. Abu Amara a, , V. Cunin b, B. Ilharreborde c

the French Society of Pediatric Orthopaedics (SOFOP)d

a Children's Surgery Clinic, université de Rouen, centre hospitalier universitaire de Rouen, 1, rue de Germont, 76031 Rouen cedex, France 
b Pediatric Orthopedics Unit, hôpital Femme-Mère-Enfant, université Lyon 1, Hospices Civils de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France 
c Children's Orthopedic Surgery Unit, université Paris Diderot, CHU Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France 
d 56, rue Boissonade, 75014 Paris, France 

Corresponding author. Tel.: +33 2 32 88 66 24; fax: +33 2 32 88 81 61.

Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.

Connectez-vous pour en bénéficier!

Abstract

Introduction

The treatment of severe slipped capital femoral epiphysis (SCFE) remains controversial. Despite numerous treatments being available, the outcome of published studies has been variable. Recent studies emphasize that poor reduction of the severe SCFE is responsible for the appearance of joint cartilage lesions and progression towards early osteoarthritis. But surgical reduction of severe SCFE also results in a significant rate of necrosis.

Objective

Evaluate the results of various treatment strategies for severe SCFE and identify the optimal course of action.

Material and methods

This was a French multicenter retrospective study of severe SCFE cases (>45° displacement) evaluated a minimum of 12months after treatment. The stability of the slipped epiphysis, type of the treatment, delay before treatment, early and short-term complications, Harris and WOMAC functional scores and radiological signs of femoroacetabular impingement (FAI) at the last review were evaluated. A total of 186 cases of severe SCFE in 182 patients were included. One hundred and seven (58.7%) of these were male. The average age was 13years. The average follow-up was 23months. The average displacement was 60°. The SCFE was considered stable in 94 cases (50.5%) and unstable in 92 cases (49.5%). The main surgical treatments used by the various centers were in situ fixation (ISF), lateral Dunn, anterior Dunn and reduction using traction or under anesthesia (for unstable forms).

Results

In the stable SCFE cases, there were 6 cases of necrosis (6.4%), all of which occurred after reduction by osteotomy; there were 32 cases of radiological FAI (34%), 30 of which occurred after ISF. The necrosis rate in the unstable SCFE cases was 21.7%: one (11%) after ISF, seven (19%) after anterior Dunn, eight (21%) after preoperative reduction and three (43%) after lateral Dunn.

Conclusions

The results of this study confirm the diverse nature of SCFE treatments available and the variability of their results. When selecting a treatment for severe SCFE, the goal is to stop the slip and also to prevent osteoarthritis by correcting the hip deformities. The “anterior” Dunn procedure was able to achieve these two goals, while having a lower complication rate than the other reduction techniques.

Level of evidence

IV.

Le texte complet de cet article est disponible en PDF.

Keywords : Slipped capital femoral epiphysis, Severe, Treatment, In situ fixation, Reduction, Osteotomy


Plan


 The French Society of Pediatric Orthopaedics.


© 2015  Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 101 - N° 6S

P. S275-S279 - octobre 2015 Retour au numéro
Article précédent Article précédent
  • Impact of cardiovascular risk factor on the prevalence and severity of symptomatic full-thickness rotator cuff tears
  • I. Djerbi, M. Chammas, M.-P. Mirous, C. Lazerges, B. Coulet, French Society For Shoulder and Elbow (SOFEC) b
| Article suivant Article suivant
  • Fusionless surgery in early-onset scoliosis
  • T. Odent, B. Ilharreborde, L. Miladi, N. Khouri, P. Violas, J. Ouellet, V. Cunin, J. Kieffer, K. Kharrat, F. Accadbled, Scoliosis Study Group (Groupe d’étude de la scoliose) j, the French Society of Pediatric Orthopedics (SOFOP) k

Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement ou un achat à l’unité.

Déjà abonné à cette revue ?

;

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.