Gutman I M, Gilbert S R
University of Alabama School of Medicine, Birmingham, Alabama, USA.
Department of Orthopaedic Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.
J Child Orthop. 2018 Oct 1;12(5):428-433. doi: 10.1302/1863-2548.12.180081.
Slipped capital femoral epiphysis (SCFE) is an adolescent hip condition with a high risk of complication. The purpose of this study was to evaluate trends in treatment using a prospectively collected paediatric nationally representative database.
A total of 9034 patients undergoing treatment for idiopathic SCFE were selected by querying the Healthcare Cost and Utilization Project's Kids' Inpatient Database for the years 1997, 2000, 2003, 2006, 2009 and 2012. The selected patients were separated based on operative approach and these cohorts were analyzed based on temporal and categorical differences in operative approach, patient demographics and clinical characteristics. Univariate and multivariate analyses were used when appropriate and the Mantel-Haenszel test for trend was used in temporal analysis.
Overall SCFE procedures have decreased 27.5% (p < 0.001). Closed procedures have decreased 28.5% (p < 0.001), while open procedures have decreased 44.8% (p < 0.001). Bilateral closed procedures have increased 7.2% (p < 0.001). The ratio of open to closed procedures decreased in patients aged nine to 12 years and increased in patients aged 13 to 16 years (p < 0.001).
Here we report age stratified trends in treatment for idiopathic SCFE using nationally representative data and show an overall decrease in admissions and procedures over time.
Level III, retrospective comparison study.
股骨头骨骺滑脱（SCFE）是一种青少年髋关节疾病，并发症风险高。本研究的目的是利用前瞻性收集的全国具有代表性的儿科数据库评估治疗趋势。
通过查询1997年、2000年、2003年、2006年、2009年和2012年医疗保健成本和利用项目的儿童住院数据库，共选择了9034例接受特发性SCFE治疗的患者。根据手术方式对所选患者进行分类，并根据手术方式、患者人口统计学和临床特征的时间和类别差异对这些队列进行分析。在适当的时候使用单变量和多变量分析，并在时间分析中使用Mantel-Haenszel趋势检验。
总体SCFE手术减少了27.5%（p<0.001）。闭合手术减少了28.5%（p<0.001），而开放手术减少了44.8%（p<0.001）。双侧闭合手术增加了7.2%（p<0.001）。9至12岁患者的开放手术与闭合手术比例下降，13至16岁患者的该比例上升（p<0.001）。
我们在此报告使用全国代表性数据得出的特发性SCFE治疗的年龄分层趋势，并显示随着时间的推移，入院和手术总体减少。
III级，回顾性比较研究。
