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Review Question - QID 3153

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QID 3153 (Type "3153" in App Search)
A 13-year-old boy complains of a 3-month history of left knee, thigh and groin pain. His pain has significantly worsened over the past week. He denies pain in the right leg. Radiographs are taken and shown in Figures A and B. The history and physical do not reveal any findings concerning for an endocrine disorder. What is the preferred method of treatment?
  • A
  • B

Subtrochanteric valgus, extension, and external rotational osteotomy

1%

31/3443

Non weight bearing on the left side for 6 weeks.

2%

58/3443

Bilateral in situ single screw insertion across the proximal femoral physis

9%

298/3443

In situ single screw insertion across the left proximal femoral physis only

87%

3006/3443

Varus derotational osteotomy of the proximal femur

1%

34/3443

  • A
  • B

Select Answer to see Preferred Response

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Acute or acute on chronic slipped capital femoral epiphysis (SCFE) can be adequately stabilized with a single percutaneous screw fixation across the proximal femoral physis.

Goodman et al retrospectively demonstrated that in situ, single screw fixation across the proximal femoral physis in patients with acute or acute on chronic SCFE, was sufficient to allow closure of the physis with no change in head-shaft angles from the preoperative radiographs.

Morrissy in an instructional course lecture, illustrates the principles of in situ fixation in chronic SCFE. Pinning of the contralateral physis should strongly be considered for boys under 12 and girls under 10, the presence of an open triradiate cartilage, or evidence of an endocrinopathy.

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