Slipped capital femoral epiphysis: A spectrum of surgical care and changes over time

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. Methods Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected. Results A total of 13 168 procedures were performed in 11 058 unique SCFE patients, or 1.2 procedures per patient. Primary procedures were those performed for the initial treatment of the SCFE and secondary procedures as reconstructive and salvage. The majority (11 693, 88.8%) were primary. There was significant variation in the ratio of primary and secondary procedures by institution. There was a decline in in situ fixation as the initial SCFE treatment with an increase in open reduction and internal fixation over the 12-year span. Similarly, there was a significant increase in the number of secondary procedures over time as well as complications and implant removal. There was no change over time in the diagnosis of avascular necrosis. Conclusions The average number of surgical procedures in patients was in the range of 1 to 6 and varied widely by hospital. Each physician should know his/her own hospital’s data for the percentage of subsequent procedures so as to counsel the patient and family properly. The increasing number of complications over time may reflect the increasing number of more complex procedures.

Original languageEnglish (US)
Pages (from-to)154-159
Number of pages6
JournalJournal of Children's Orthopaedics
Volume11
Issue number2 Special Issue
DOIs
StatePublished - 2017

Fingerprint

Slipped Capital Femoral Epiphyses
Hospital Information Systems
Pediatric Hospitals
Hospital Records
Therapeutics
Child Care
Medical Records
Counseling
Length of Stay
Necrosis

Keywords

  • Avascular necrosis
  • Complications
  • SCFE
  • Slipped capital femoral epiphysis
  • Treatment

ASJC Scopus subject areas

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

Cite this

Slipped capital femoral epiphysis : A spectrum of surgical care and changes over time. / Loder, Randall.

In: Journal of Children's Orthopaedics, Vol. 11, No. 2 Special Issue, 2017, p. 154-159.

Research output: Contribution to journalArticle

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abstract = "Purpose To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. Methods Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected. Results A total of 13 168 procedures were performed in 11 058 unique SCFE patients, or 1.2 procedures per patient. Primary procedures were those performed for the initial treatment of the SCFE and secondary procedures as reconstructive and salvage. The majority (11 693, 88.8{\%}) were primary. There was significant variation in the ratio of primary and secondary procedures by institution. There was a decline in in situ fixation as the initial SCFE treatment with an increase in open reduction and internal fixation over the 12-year span. Similarly, there was a significant increase in the number of secondary procedures over time as well as complications and implant removal. There was no change over time in the diagnosis of avascular necrosis. Conclusions The average number of surgical procedures in patients was in the range of 1 to 6 and varied widely by hospital. Each physician should know his/her own hospital’s data for the percentage of subsequent procedures so as to counsel the patient and family properly. The increasing number of complications over time may reflect the increasing number of more complex procedures.",
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