Santili Cláudio, Akkari Miguel, Waisberg Gilberto, Braga Susana Reis, Kasahara Akemi, Perez Mauro Coura
PhD in Orthopedics. Adjunct Professor and Senior Member of the Pediatric Orthopedics Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
MSc and PhD in Orthopedics. Head of the Pediatric Orthopedics Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa de São Paulo.
Rev Bras Ortop. 2015 Dec 12;45(5):397-402. doi: 10.1016/S2255-4971(15)30426-2. eCollection 2010 Sep-Oct.
To evaluate the efficacy of conservative treatment of patients with slipped capital femoral epiphysis (SCFE) and the complications due to the progression of the disease.
18 patients (26 hips) seen consecutively from December 1996 to August 2006 at the Orthopedics Service of Santa Casa de Misericórdia de São Paulo, who had been referred from other services with a diagnosis of SCFE and were treated without surgery, were retrospectively analyzed.
Slip progression occurred in 19 hips (73%). Among the mild cases, eight remained mild, four became moderate and one became severe, according to the Southwick classification. Four out of the six originally moderate cases became severe and the two already severe cases worsened.
Although today there is a consensus regarding the indication of surgical treatment for SCFE to prevent progression, some cases with confirmed diagnoses are still being treated conservatively. This is a major error, since it implies increased morbidity of the disease.
评估保守治疗股骨头骨骺滑脱（SCFE）患者的疗效以及疾病进展导致的并发症。
回顾性分析1996年12月至2006年8月期间在圣保罗慈善医院骨科连续就诊的18例患者（26髋），这些患者由其他科室转诊而来，诊断为SCFE且接受了非手术治疗。
19髋（73%）出现滑脱进展。根据索思威克分类，轻度病例中，8例仍为轻度，4例变为中度，1例变为重度。6例最初为中度的病例中有4例变为重度，2例已为重度的病例病情恶化。
尽管如今对于SCFE手术治疗以预防进展的指征已达成共识，但一些确诊病例仍在接受保守治疗。这是一个重大错误，因为这意味着疾病发病率增加。
