Abstract
Introduction: Slipped capital femoral epiphysis (SCFE) is a common hip disorder in adolescents. The most serious complication is avascular necrosis (AVN), which has lasting sequelae. The objective of this study was to determine the rate of AVN in stable slips. Method: We reviewed retrospectively all the children treated for SCFE between 2004 and 2008 at Princess Margaret Hospital. Results: Of a total of 67 patients, 51 (76%) were stable slips and 16 (24%) unstable. Avascular necrosis developed in 3 patients with stable slip (5.9%) and in 6 with unstable slip (37.5%). There was no statistically significant association found between AVN and age, weight, slip severity, pin position, number of pins used, experience of the surgeon or side affected. Those with stable presentations can develop AVN2, males are more likely and the possibility of developing AVN increases as the time from presentation to operation increased. Conclusion: AVN can occur in stable slips without joint penetration. This combined with male sex and increased time to operation, increases the risk of AVN.
Highlights
Slipped capital femoral epiphysis (SCFE) is a common hip disorder in adolescents
Our objective was to determine if the rate of avascular necrosis (AVN) for stable slips is 0% as proposed by Loder [5] and other authors [1] [6] [7], and the factors that influence the development of AVN in SCFE
Avascular necrosis developed in 3 patients with stable slip (5.9%) and in 6 with unstable slip (37.5%)
Summary
Slipped capital femoral epiphysis (SCFE) is a common hip disorder in adolescents. There was no statistically significant association found between AVN and age, weight, slip severity, pin position, number of pins used, experience of the surgeon or side affected. Those with stable presentations can develop AVN2, males are more likely and the possibility of developing AVN increases as the time from presentation to operation increased. (2014) Analysis of the Development of Avascular Necrosis in Slipped Capital Femoral Epiphysis. This rapid growth is associated with an increased chondrocyte proliferation rate and increased height of the zone of hypertrophy [2]. This zone is wider than normal, with disordered chondrocyte columns, decreased number of cells, smaller cells and increased number of dead and degenerative cells [3] [4]
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