Surgical Treatment of Slipped Capital Femoral Epiphysis

Song, Kwang Soon; Yang, Ho Jun

Abstract

PURPOSE: The aim of this article is to define the safety and effectiveness of in situ pin fixation in treatment of SCFE (Slipped Capital Femoral Epiphysis).
MATERIALS AND METHODS
The author reviewed 14 cases in 13 patients. The mean follow-up period was 38 months. The methods of treatment were divided into two groups. The group A: 4 cases were treated with closed reduction followed by multiple pinning before 1986, and group B: 9 cases were treated with in situ fixation followed by multiple pinning (3 cases) or one central ASNIS screw (6 cases) after 1986.
RESULTS
Before 1986, high incidence of complications (Avascular necrosis change followed by severe osteoarthritis) were noted after closed reduction (2/4). In contrast, 9 cases of in situ fixation were well united without further slippage or specific complication such as avascular necrosis or chondrolysis. One case was involved bilaterally and found incidentally during follow up check without any subjective symptom. One case was developed as a manifestation of osteogenesis imperfecta. Failure of removal of the fixated screws (Knowles pin 8 Titanium cannulated screw) were in 3 cases.
CONCLUSIONS
Closed reduction may be a very dangerous procedure, increasing the rate of complication in spite of its necessity. We considered that closed reduction should be avoided regardless of the severity of the displacement in chronic case.