Document Detail


The utility of posterior sloping angle in predicting contralateral slipped capital femoral epiphysis.
MedLine Citation:
PMID:  20864853     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Prophylactic pinning of the uninvolved side after unilateral slipped capital femoral epiphysis (SCFE) is controversial. The posterior sloping angle (PSA) has previously been proposed to predict contralateral slip. The purpose of this study was to determine whether the PSA can predict subsequent slip after unilateral SCFE, and if so, whether a sex difference exists.
METHODS: A retrospective case-control study was performed comparing 51 patients who initially presented with unilateral SCFE and subsequently developed contralateral slip (Bilateral) with 51 patients who had unilateral SCFE only (Unilateral). Data collected included age, sex, ethnicity, and PSA.
RESULTS: The patients in the Bilateral group had significantly higher PSA (14.5±6.1 vs. 10.6±5.3, P=0.001) and were younger (11.3±1.5 vs.12.3±1.2, P<0.001) than the patients in the Unilateral group. A receiver-operating characteristic curve demonstrated that the threshold for pinning a contralateral hip with PSA >12.66 yields an area under the curve of 67%. When the analysis was repeated with respect to sex, girls in the Bilateral group had significantly higher PSA (15.9±6.3 vs. 10.1±6.0, P=0.002) and were younger (10.7±1.1 vs.11.9±1.0, P<0.001) than the girls in the Unilateral group. Among boys, these associations were not significant. A receiver-operating characteristic curve demonstrated that the threshold for pinning a contralateral hip with PSA >13 in girls yields an area under the curve of 76%.
CONCLUSIONS: PSA is predictive of contralateral slip in patients presenting with unilateral SCFE. However, it is more predictive in girls, and we recommend considering prophylactic pinning in girls with PSA >13.
LEVEL OF EVIDENCE: Level III.
Authors:
Sangdo Park; Jason E Hsu; Norma Rendon; Hayley Wolfgruber; Lawrence Wells
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  30     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:    2010 Oct-Nov
Date Detail:
Created Date:  2010-09-24     Completed Date:  2011-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  683-9     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, The Childrens Hospital of Philadelphia, Philadelphia, PA 19104-4399, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Case-Control Studies
Child
Epiphyses, Slipped / radiography*
Female
Femur / radiography*
Follow-Up Studies
Hip / radiography*
Humans
Male
Orthopedic Procedures / methods
Predictive Value of Tests
ROC Curve
Retrospective Studies
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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