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Slipped capital femoral epiphysis in children younger than 10 years old: clinical characteristics and efficacy of physeal-sparing procedures

Song, Mi Hyuna; Jang, Woo Youngb; Park, Moon Seokd; Yoo, Won Joonc; Choi, In Hoc; Cho, Tae-Joonc

Journal of Pediatric Orthopaedics B: September 2018 - Volume 27 - Issue 5 - p 379–386
doi: 10.1097/BPB.0000000000000485
PELVIS, HIP & FEMUR

We aimed to investigate the clinical characteristics of slipped capital femoral epiphysis (SCFE) in patients aged less than 10 years and identify the efficacy of physeal-sparing procedures in this age group. Demographic data of 18 SCFE patients aged less than 10 years were compared with those of 71 older patients to investigate the clinical characteristics. The efficacy of physeal-sparing procedures (n=5) was investigated compared with that of in-situ screw fixation (n=13). Obese children were noticeably more common among SCFE patients aged less than 10 years (P=0.034). The slip angle improved significantly more in the physeal-sparing subgroups (P=0.038) without the occurrence of further slippage. Moreover, physeal-sparing procedures allow persistent growth of the proximal femoral physis. However, most of the patients in the physeal-sparing subgroup needed additional surgeries when the proximal femoral physis outgrew the implant. Obesity may be associated more with early-onset SCFE (onset<10 years). Physeal-sparing procedures are safe and effective in preventing leg-length discrepancy and allowing the remodeling of the deformed proximal femur in this age group.

aDepartment of Orthopaedic Surgery, Jeju National University School of Medicine, Jeju National University Hospital, Jeju

bDepartment of Orthopaedic Surgery, Korea University Medical Center Anam Hospital

cDivision of Pediatric Orthopaedics, Seoul National University Children’s Hospital, Seoul

dDepartment of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seongnam, Republic of Korea

Correspondence to Tae-Joon Cho, MD, Division of Pediatric Orthopaedics, Seoul National University Children’s Hospital, 101 Daehak-ro, Jongno-gu, 110-744 Seoul, Republic of Korea Tel: +82 2 2072 2878; fax: +82 2 745 3367; e-mail: tjcho@snu.ac.kr

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