Slipped capital femoral epiphysis: A retrospective review of the clinical and radiological results

IN a retrospective study on 70 hips with slipping of the upper capital femoral epiphysis, the importance of early diagnosis and treatment is emphasised. A higher incidence of avascular necrosis developed in hips that were manipulated (8.4%) than in hips where the deformity was accepted and pinned in situ (3.4%). Avascular necrosis developed where there was a moderate or severe degree of displacement and acute and chronic type of slipping. It is suggested in this series that manipulation per se was not totally responsible for the development of avascular necrosis and that other factors like trauma and secondary operative procedures contribute to its development. Females were at a considerably higher risk of developing bilateral slipping. As a salvage procedure intertrochanteric osteotomy without removing a cuneiform wedge produced fair results although inevitably degenerative changes will develop later in life.