Slipped Capital Femoral Epiphysis Treatment

Study Overview
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Brief Summary
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Slipped capital femoral epiphysis represents approximately 10.8 cases per 100,000 children. The primary source for the blood supply of the head of the femur is the deep branch of the medial femoral circumflex artery. Loder described a classification for Slipped capital femoral epiphysis based on ability of the child to walk or not(walking=stable, non-walking=unstable).

Detailed Description
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In slipped capital femoral epiphyses (SCFE), the severity of slippage correlates with poor long-term clinical outcome scores and radiographic evidence of osteoarthritis . In situ fixation of higher-grade SCFE has a low surgical risk and has been advocated by authors who believe the deformed hip has the potential to remodel with some restoration of the disturbed anatomic axes ; however, the remodeling potential remains controversial . Despite remodeling, the head-neck offset will remain abnormal . This is the cause of potential impingement of the femoral neck with the acetabular cartilage . Impingement in SCFE has been associated with damage of the acetabular cartilage, which may explain the early onset of osteoarthritis after SCFE . Ganz et al. described a technique of surgical dislocation of hip involving trochanteric flip osteotomy and anterior capsulotomy preserving the blood supply to femoral head. The technique is based on extensive study of blood supply to the proximal femur. This technique allows us to completely dislocate the joint which allows complete access to intra articular pathology and allow reduction of the slipped capital femoral epiphysis .

Official Title
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Safe Surgical Dislocation in Slipped Capital Femoral Epiphysis

Conditions
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SCFE

Intervention / Treatment
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* Procedure: Surgical dislocation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 1- Patients with moderate Slipped capital femoral epiphysis 2- Patients with severe Slipped capital femoral epiphysis Exclusion Criteria: Patients with mild Slipped capital femoral epiphysis

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Surgical dislocation<br>Reduction of slipped epiphysis via surgical dislocation technique | Procedure: Surgical dislocation<br>* Reduction of slipped epiphysis by surgical dislocation<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Harris Hip Score | this is a score for post operative evaluation of the hip (it is evaluate pain, support, Distance walked, Limp, Activities - shoes, socks, Stairs, Public transportation, Sitting, Range of motion) every item take a number then the summation of all numbers which ranged from 0 to 100 : <70 Poor 70 - 79 Fair 80-89 Good 90 -100 Excellent | 6 months |