Mid-term results of concomitant epiphyseal fixation and trochanteric osteotomy for severe chronic slipped capital femoral epiphysis.

The management of severe forms of slipped capital femoral epiphysis (SCFE) has been the subject of intense debate in the literature, and controversy remains as to whether the proximal femoral epiphysis should be realigned by intracapsular or extracapsular osteotomies or just fixated in situ. The aim of this study is to evaluate the late results of treatment of severe unreduced slipped capital femoral epiphyses by combined epiphyseal stabilisation in situ using a single cancellous screw and biplane corrective trochanteric osteotomy. Eighteen hips with severe chronic slipped capital femoral epiphysis before physeal closure were treated by combined epiphyseal fixation in situ using a single cancellous screw, and biplane corrective osteotomy fixed by an angled blade plate. The average follow-up period was 8 years. All patients achieved near-normal hip flexion, internal rotation and abduction, and most were able to bear weight in the early postoperative period. A satisfactory correction of the head-shaft angle was obtained post-operatively on both antero-posterior and frog leg lateral radiographs. There was no instance of chondrolysis, avascular necrosis or early osteoarthrosis. This procedure appears to offer a workable solution to the problem posed by the severely slipped capital femoral epiphysis.