Prophylactic fixation of the unaffected contralateral side in children with slipped capital femoral epiphysis seems favorable:A systematic review  

作　　者：Steven J C Vink Renée A van Stralen Sophie Moerman Christiaan J A van Bergen 

机构地区：[1]Department of Orthopedic Surgery,Erasmus Medical Center,Rotterdam 3015GD,Netherlands [2]Department of Orthopedic Surgery,University Medical Center Groningen,Groningen 9713GZ,Netherlands [3]Department of Orthopedic Surgery,Amphia Hospital,Breda 4818CK,Netherlands

出　　处：《World Journal of Orthopedics》2022年第5期515-527,共13页世界骨科杂志（英文版）

摘　　要：BACKGROUND Slipped capital femoral epiphysis(SCFE)occurs in adolescents and has an incidence of around 10 per 100000 children.Children presenting with a unilateral SCFE are 2335 times more likely to develop a contralateral SCFE than the general population.Prognostic factors that have been suggested to increase the risk of contralateral slip include a younger patient,an underlying endocrine disorder,growth hormone use and a higher radiographic posterior sloping angle.However,there is still much debate on the advantages and disadvantages of prophylactic fixation of the unaffected side in an otherwise healthy patient.AIM To investigate the risk rate of contralateral SCFE and assess the(dis)advantages of prophylactic fixation of the contralateral hip.METHODS A systematic literature search was performed in the Embase,Medline,Web of Science Core Collection and Cochrane databases.Search terms included‘slipped capital femoral epiphysis,’‘fixation,’‘contralateral,’and derivatives.The eligibility of the acquired articles was independently assessed by the authors and additional relevant articles were included through cross-referencing.Publications were considered eligible for inclusion if they presented data about otherwise healthy children with primarily unilateral SCFE and the outcomes of prophylactically pinning their unaffected side,or about the rates of contralateral slips and complications thereof.The study quality of the included articles was assessed independently by the authors by means of the methodological index for non-randomized studies criteria.RESULTS Of 293 identified unique publications,we included 26 studies with a total of 12897 patients.1762 patients(14%)developed a subsequent symptomatic contralateral slip.In addition,38%of patients developed a subsequent slip on the contralateral side without experiencing clinical symptoms.The most outspoken advantage of prophylactic fixation of the contralateral hip in the literature is prevention of an(asymptomatic)slip,thus reducing the increased risk of

关 键 词：Slipped capital femoral epiphysis Primary prevention Postoperative complications Risk factors RADIOGRAPHY 

分 类 号：R726.8[医药卫生—儿科]