SUFE: Early Management - Gavin Jennings 21/2/2002

Authors

R.Betz, H.Steel, W.Emper et al

Title

Treatment of Slipped Capital Femoral Epiphysis

Reference

JBJS A Vol 72 No 4 p587- 599 1990

Summary

Average 4 yr follow up of 37 hips (32 patients) with acute on chronic/ chronic SUFE treated with traction then casting in spica for eight to sixteen weeks until metaphyseal lucency had disappeared. Results –5 chondrolysis, no AVN

Critique

Short follow up. Only radiographs used to assess for AVN

Authors

G.Hansson, I.Billing, et al

Title

Long-term results after nailing in situ of slipped upper femoral epiphysis

Reference

JBJS B Vol 80B No 1p70 1998

Summary

Review of 59 hips ( in 43 patients) with chronic SUFE mean 30.9 yrs post in situ nailing. Grouping as per slip angle(SA). Radiographic assessment of OA and Harris Hip Scores. 88% excellent(HHS> 90). Recommend single nail for SA <50 °

Critique

Retrospective. Original radiographs not available in 5 hips. 70 % had SA<30 °

Authors

B.Carney, S.Weinstein et al

Title

Long-Term Follow-up of Slipped Capital Femoral

Reference

JBJS A Vol.73 No5 p667 1991

Summary

Review 155 hips (124 pts.) at mean 41 years post symptom onset. Radiographic assessment and Iowa Hip Score Regardless of slip severity in situ pinning gave best results

Critique

Retrospective. 35% not examined clinically( questionnaire). Original radiographs in only 39%

Authors

N.S.Broughton, R.Todd, D.M.Dunn, J. Angel

Title

Open Reduction of the Severely Slipped Upper Femoral Epiphysis

Reference

JBJS B Vol 70 p435 1988

Summary

115 open reductions (110 pts) mean follow up 12yrs 11mo. Assessment- subjective, radiological and ROM. Chronic slips(70)- low complication rate 2 AVN, 1 chondrolysis. Acute on chronic(38)- 6 AVN 1 chondrolysis, 3 had both. Partially fused epiphysis(7)- poor only 1 did well.

Critique

Fairly short follow up in terms of development of OA