High-grade SCFE: The role of surgical hip dislocation and reduction

Daniel J. Sucato, Adriana De La Rocha

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

The patient with an unstable slipped capital femoral epiphsyis poses a challenging problem to the treating physician to improve the position of the displaced epiphysis to avoid femoroacetabular impingement without developing avascular necrosis (AVN)-a potentially devastating complication. Although the standard operative procedure of in situ pinning following an incidental reduction while positioning the patient on the table, has been the mainstay of treatment in North America, other viable options are available including a surgical dislocation approach to the hip followed by a modified Dunn osteotomy with control of the retinacular vessels, reduction of the epiphysis, and internal fixation with pins or screws. Although technically demanding, this approach offers an opportunity to reduce the epiphysis to avoid femoroacetabular impingement, and limit the possibility for the development of AVN. The early results for this procedure are promising with all studies demonstrating excellent reduction of the epiphysis and an overall lower incidence of AVN when compared with in situ pinning.

Original languageEnglish (US)
Pages (from-to)S18-S24
JournalJournal of Pediatric Orthopaedics
Volume34
DOIs
StatePublished - Jan 1 2014

Keywords

  • Avascular necrosis
  • Slipped capital femoral epiphysis
  • Surgical hip dislocation
  • Unstable

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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