Abstract
BackgroundTreatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The conservative treatment remains controversial; it has been overlooked in the studies and subjected to intense criticism. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using the plaster cast immobilization method and its link to chondrolysis.MethodsThe research was performed based on the study of the following variables: symptomatology, and the degree of slipping. A hip spica cast and bilateral short/long leg casts in abduction, internal rotation with anti-rotational bars were used for immobilizing the patient's hip for twelve weeks. Statistical analysis was accomplished by Wilcoxon's marked position test and by the Fisher accuracy test at a 5% level.ResultsA satisfactory result was obtained in the acute group, 70.5%; 94%; in the chronic group (chronic + acute on chronic). Regarding the degree of the slipping, a satisfactory result was obtained in 90.5% of hips tested with a mild slip; in 76% with moderate slip and 73% in the severe slip. The statistical result revealed that a significant improvement was found for flexion (p = 0.0001), abduction (p = 0.0001), internal rotation (p = 0.0001) and external rotation (p = 0.02). Chondrolysis was present in 11.3% of the hips tested. One case of pseudoarthrosis with aseptic capital necrosis was presented. There was no significant variation between age and chondrolysis (p = 1.00).Significant variation between gender/non-white patients versus chondrolysis (p = 0.031) and (p = 0.037), respectively was verified.No causal association between plaster cast and chondrolysis was observed (p = 0.60). In regard to the symptomatology group and the slip degree versus chondrolysis, the p value was not statistically significant in both analyses, p = 0.61 and p = 0.085 respectively.ConclusionsAfter analyzing the nonoperative treatment of slipped capital femoral epiphysis and chondrolysis, we conclude that employment of the treatment revealed that the method was functional, efficient, valid, and reproducible; it also can be used as an alternative therapeutic procedure regarding to this specific disease.
Highlights
Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis
Patients and Methods The Committee of Ethics of the Jesus Children’s Hospital in Brazil, Rio de Janeiro, have analyzed and approved the Research Project entitled, Nonoperative treatment of slipped capital femoral epiphysis, which was evaluated by the Ethics Committee for Research of the Federal University of Rio de Janeiro (UFRJ), Brazil
After analyzing the nonoperative treatment in slipped capital femoral epiphysis and chondrolysis, we concluded that the employment of the treatment revealed that the method was functional, efficient, valid, and reproducible; it can be used as an alternative therapeutic procedure regarding to this specific disease
Summary
Treatment of the Slipped Capital Femoral Epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications: chondrolysis. The purpose of this study is to investigate the results of treatment on the hip of patients displaying slipped capital femoral epiphysis, using the plaster cast immobilization method and its link to chondrolysis. - applicability: non-operative treatment of SCFE allows the use of this method at any hospital, even for surgeons who have very little hands-on experience with this specific disease;. - knowledge: this research offers the opportunity for orthopedic surgeons to employ a method based on biology, contributing to further knowledge of SCFE, thereby promoting the possibility of a wide debate on the subject;. - therapeutic: the use of the plaster cast method revealed the possibility of obtaining favorable results for its use;. This work posits that the benefits and application of the therapeutic criteria based on biology comprise a valid method of treatment, considering disease prognostic uncertainty
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