Premature closure of the physeal plate after treatment of a slipped capital femoral epiphysis.

BACKGROUND

Treatment of a slipped capital femoral epiphysis (SCFE) should stabilize the epiphysis and prevent complications. Attempting to obtain physeal closure is still controversial. The purpose of this study was to evaluate the clinical results and complications after treatment of SCFE.

METHODS

From 1989 to 2000, 12 patients (14 hips) underwent pinning for treatment of SCFE. For acute and acute-on-chronic slippage, longitudinal traction was attempted for reduction. Patients with chronic slippage received fixation in situ. All patients were available for follow-up for an average of 63 months.

RESULTS

Nine of the 14 hips had excellent or good functional results, and 5 had fair results. One hip developed avascular necrosis of the femoral head with a fair result. There was no chondrolysis or osteoarthritis of the joint at the most recent follow-up. Physeal closure in 9 hips occurred at an average of 16 months. The change in articulotrochanteric distance averaged 5.4 mm.

CONCLUSION

Although most functional results were not adversely influenced after premature closure of the physeal plate of consideration should be given to the device, such as a dynamic screw, that stabilizes the epiphysis and prevents premature physeal closure in patients who have significant growth potential. To understand the influence of growth disturbance of the proximal femur and the effect of dynamic screw fixation, long-term follow-up is mandatory.