This 2001 instructional course lecture by Loder focuses specifically on unstable SCFE — defined as inability to bear weight with or without crutches — reviewing its clinical presentation, imaging workup, surgical options, and the management of its two major complications: avascular necrosis and chondrolysis.
50% articular space loss (unilateral cases)
When a child cannot bear weight after acute hip pain — even with crutches.
Classify the SCFE as unstable, counsel the family about AVN risk up to 47%, avoid forceful reduction maneuvers (vascular damage is likely already done at the time of displacement), and fix with a single cannulated screw placed centrally in the epiphysis on both AP and lateral views.
Follow closely for AVN and chondrolysis, both of which typically declare themselves within the first 12 months.
This 2001 instructional course lecture by Loder focuses specifically on unstable SCFE — defined as inability to bear weight with or without crutches — reviewing its clinical presentation, imaging workup, surgical options, and the management of its two major complications: avascular necrosis and chondrolysis.
50% articular space loss (unilateral cases)
When a child cannot bear weight after acute hip pain — even with crutches.
Classify the SCFE as unstable, counsel the family about AVN risk up to 47%, avoid forceful reduction maneuvers (vascular damage is likely already done at the time of displacement), and fix with a single cannulated screw placed centrally in the epiphysis on both AP and lateral views.
Follow closely for AVN and chondrolysis, both of which typically declare themselves within the first 12 months.