Journal List > J Korean Orthop Assoc > v.27(1) > 1114325

Shim, Choi, Chung, and Lee: Slipped Capital Femoral Epiphysis

Abstract

Slipped capital femoral epiphysis(SCFE) is a well-known adolescent hip disorder with a lower incidence in Korean. The poorer prognosis has been attributed to a higher incidence of avascular necrosis, chondrolysis and early degenerative arthritis. The goal of treatment is to correct the displacement with a minimun of trauma and to prevent further slipping by stabilization of the lesion until bony union between the neck and the epiphysis has been taken. We report on 10 patients (12 hips) with SCFE who were treated by surgical means and followed along for more than one year, at the Seoul National University Children's Hospital, from 1986 through 1990. There were nine boys and one girl. The average age at operation was 11.9 years. The slipping was 4 acute, 2 acute-on-chronic and 6 chronic onset. All 4 mild slips were treated by insitu pinning, whereas 6 moderate slips were treated by either multiple pinning following gentle closed reduction (3 hips) or insitu pinning (3 hips). Of 2 severe slips, one was treated by insitu pinning and the other by modified trapezoidal osteotomy of the neck. On the average follow-up of 2.1 yeras, 11 out 12 hips had either excellent or good functional results. There was not any case having either chondrolysis or avascular necrosis, although one hip had fair result with early degenerative arthritis. In conclusion, we believe that avascular necrosis or chondrolysis can be avoided by careful preoperative planning, skillful surgical technique and attentive postoperative care.

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