Surgical treatment of femoroacetabular impingement after slipped capital femoral epiphysis.

Abstract:

PURPOSE OF REVIEW:Femoroacetabular impingement (FAI) post slipped capital femoral epiphysis (SCFE) may lead to degenerative changes on the hip. We have reviewed the current procedures in the literature, aiming to correct the SCFE to prevent FAI and the ones that treat FAI post SCFE. RECENT FINDINGS:The trends of managing moderated or severe SCFE is to correct the displacement by reduction and fixation with articular hematoma decompression in unstable hips and Dunn modified procedure even for unstable and stable situations. However, after FAI is settled, the options are osteochondroplasty by arthroscopy or surgical hip dislocation, associated or not to subtrocanteric osteotomy. SUMMARY:Femoroacetabular impingement may occur in mild slips and certainly occur in cases of moderate and severe slips. The initial management depends on the severity and the stability of the slip.The modified Dunn procedure is a good option for the treatment of unstable SCFEs. Gentle closed reduction with capsulotomy (Parsch) may be considered whenever the surgeon is not comfortable with the modified Dunn procedure.Hips with open physis and stable moderate or severe SCFE, the modified Dunn procedure can be indicated. Cases with closed physis are managed with intertrochanteric osteotomy combined with osteoplasty.In the presence of symptomatic FAI secondary to SCFE, one should consider arthroscopic osteoplasty or surgical hip dislocation (with or without osteotomies) as treatment options.

journal_name

Curr Opin Pediatr

authors

Soni JF,Valenza WR,Uliana CS

doi

10.1097/MOP.0000000000000565

subject

Has Abstract

pub_date

2018-02-01 00:00:00

pages

93-99

issue

1

eissn

1040-8703

issn

1531-698X

journal_volume

30

pub_type

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