Table 4: Therapeutic options for stable and unstable SCFE.

Stable+
Treatment Method AVN % CL % FAI % Patient Satisfaction Indication* Comments*
Pinning Using Single Screw 1.4 2.1 29.8 47% excellent
36% good
First option for mild –moderate.
Can be used in severe stable
Screws that allow continued growth should be chosen in relation to standard screws
Pinning Using Multiple Pins 2.2 4 NR 67% excellent
17% good
Good alternative to mild-moderate Is often chosen in 2nd option with Pinning using single screw
Physeal Osteotomy 11.1 9.8 1.5 28% excellent
45% good
Good option for severe stable intracapsular cuneiform osteotomies of
Dunn and Fish
Bone Graft Epiphysiodesis 3 1.3 NR 67% excellent
06% good
Alternative for severe Less used by orthopedists: blood loss, donor site morbidity, length of surgical time and length of stay
Hip Spica 9.5 20.5 NR NR Obsolete option in developed countries A relative option for mild to moderate SCFE in LCIs
Ganz Surgical Dislocation 3.1 2.1 6 87% excellent
03% good
Alternative for severe stable Very high patient satisfaction after intervention, but high risk of AVN
Unstable
Pinning in situ 33 NR NR NR Mild to moderate Highest rate of AVN
Closed Reduction and Pinning 26 NR NR Moderate to severe Lire 101
Open Reduction and
Internal Fixation
5 NR NR NR severe Is associated with the lowest rate of AVN
Open Reduction and
Physeal Osteotomy
17 NR NR NR severe restore the proximal femoral anatomy Lire 101
Ganz Surgical Dislocation 18 NR NR NR severe Lire 101
Epiphysiodesis 9 NR NR Severe Chronic symptoms

AVN: Avascular necrosis; CL: FAI: + Gutman IM et al. [19]
* Comments come from an analysis of the authors
Naseem et al. [20]