Skip Navigation LinksHome > September 2012 - Volume 32 - Issue > What Is the Best Evidence for the Treatment of Slipped Capit...
Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0b013e318259f2d1
EBM Supplement

What Is the Best Evidence for the Treatment of Slipped Capital Femoral Epiphysis?

Loder, Randall T. MD*,†; Dietz, Frederick R. MD

Collapse Box

Abstract

Background: There are many different treatment methods for slipped capital femoral epiphysis (SCFE). It was the purpose of this study to review the results from the literature for different methods of SCFE treatment and on the basis of level of evidence determine the current best evidence treatment.

Methods: A systematic review of the literature was undertaken. Treatment results were grouped into 2 categories. The first was all methods without surgical hip dislocation, and the second was all methods in which surgical dislocation was used.

Results: For stable SCFEs without surgical dislocation, the best recommended treatment (mostly level IV) recommends in situ single screw fixation over multiple pin fixation, epiphysiodesis, osteotomy, or spica cast. For the unstable SCFEs without surgical dislocation (all level IV), the best recommended treatment is urgent reduction with decompression and internal fixation. For both stable and unstable SCFEs, the short-term small series in the literature (all level IV) does not demonstrate an advantage or improvement in outcomes compared with in situ single screw fixation for stable SCFE and urgent reduction, decompression, and internal fixation in unstable SCFEs.

Conclusions: A systematic review of the literature recommends on the basis of level of evidence that the best treatment for a stable SCFE is single screw in situ fixation and for unstable SCFEs urgent gentle reduction, decompression, and internal fixation.

Level of Evidence: Level IV, systematic review of level IV studies.

© 2012 Lippincott Williams & Wilkins, Inc.

The Pediatric Orthopaedic Society of North America (POSNA)
is a group of healthcare professionals, primarily pediatric orthopaedic surgeons, dedicated to advancing musculoskeletal care of children and adolescents. JPO is our official member journal. 
Like us on facebook and become a member today!

Login

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.