RADIOLOGICAL RESULTS OF SEVERE SCFE TREATMENT AT IOT-FMUSP FROM 2012 TO 2018

To assess the complications in patients with severe slipped capital femoral epiphysis treated with the Dunn or modified Dunn procedure from 2012 to 2018 at the Institute of Orthopedics and Traumatology, Medical School, Universidade de São Paulo.

Methods:

Analysis of medical records, preoperative and postoperative radiographs with at least one year of radiographic follow-up of patients with severe slipped capital femoral epiphysis.

Results:

We reviewed the complications in 19 operated cases from 2012 to 2018, out of which 36.8% had osteonecrosis of the femoral head, one patient had chondrolysis, and another had postoperative infection.

Conclusion:

The osteonecrosis rate observed in this series of cases is similar to that described in other orthopedic facilities. We assessed factors that could potentially influence this outcome, including other characteristics of the patient (obesity, endocrine diseases, and history of sports activities) and of the health system. Level of Evidence III, Restropective Case Series.

Keywords:
Slipped Capital Femoral Epiphyses; Osteonecrosis; Osteotomy; Dunn Procedure; Modified Dunn Procedure; Southwick Angle

Characteristic			n = 19
Characteristic			n (%)
Age (years)	Mean (SD)	11.9 (1.8)
Age (years)	Median (min-max)	12 (9-17)
Sex	Female		11 (57.9%)
Sex	Male		8 (42.1%)
Laterality	Right		12 (63.2%)
Laterality	Left		7 (36.8%)

Characteristic	n = 19	Osteonecrosis		p-value
		Yes	No
		n = 7 (36.8%)	n = 12 (63.2%)
Sex	Female	2 (18.2%)	9 (81.8%)	0.074¹
Sex	Male	5 (62.5%)	3 (37.5%)	0.074¹
Age	Mean (SD)	11.9 (1.8)	11.9 (1.9)	0.793²
Age	Median (min-max)	12.0 (9-14)	11.5 (10-17)	0.793²
Laterality	Right	5 (41.7%)	7 (58.3%)	0.656¹
Laterality	Left	2 (28.6%)	5 (71.4%)	0.656¹
Affected side	Mean (SD)	92.9 (22.1)	91.6 (31.7)	0.582²
Affected side	Median (min-max)	81.0 (79-138)	81.5 (64-165)	0.582²
Normal side	Mean (SD)	21.3 (24.1)	28.2 (31.3)	0.703²
Normal side	Median (min-max)	15.0 (1-72)	16.0 (2-99)	0.703²
Southwick angle	Mean (SD)	71.6 (15.9)	63.3 (10.7)	0.204²
Southwick angle	Median (min-max)	66.0 (57-105)	61.5 (50-80)	0.204²

Patient	Age	Sex	Laterality	Affected Side	Normal Side	Southwick angle	Osteonecrosis
Patient 1	12	male	right	72	19	53	no
Patient 2	12	female	left	82	2	80	no
Patient 3	11	female	left	81	13	68	no
Patient 4	14	female	right	82	19	63	no
Patient 5	12	male	right	80	23	57	yes
Patient 6	12	male	left	80	15	65	yes
Patient 7	11	female	right	86	24	62	yes
Patient 8	14	male	right	138^*	72^*	66	yes
Patient 9	11	male	right	78	23	55	no
Patient 10	11	female	right	88	32	56	no
Patient 11	11	female	left	64	9	55	no
Patient 12	11	female	right	79	3	76	yes
Patient 13	12	female	left	70	10	60	no
Patient 14	12	male	left	149^*	99^*	50	no
Patient 15	10	female	right	92	13	79	no
Patient 16	17	female	right	165^*	87^*	78	no
Patient 17	10	female	right	76	13	63	no
Patient 18	9	male	right	81	11	70	yes
Patient 19	14	male	left	106	1	105	yes

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[1] Correspondence: Edelvan Gabana. Rua Dr. Ovídio Pires de Campos, 333, São Paulo, SP, Brazil, 05403010. edegabana@gmail.com