Treatment of slipped capital femoral epiphysis: evaluation of the results of extracapsular epiphysiodesis and open reduction-epiphysiodesis.

The authors review 26 patients who underwent either "in situ" extracapsular epiphysiodesis or intracapsular reduction followed by epiphysiodesis for slipped capital femoral epiphysis (SCFE). A total of 32 operations were performed. In the first group (chronic grade II SCFE), no complications occurred in the 16 operations and the results were excellent in all cases. In the second group (chronic grade II and III SCFE and acute-on-chronic SCFE), in 16 operations we observed four cases of avascular necrosis, two of which accompanied by chondrolysis. Three of these were in cases of acute-on-chronic SCFE. The results confirm that the cases of acute-on-chronic SCFE have the worst prognosis and a much higher risk of avascular necrosis and/or chondrolysis than purely chronic SCFE. Early diagnosis of ischemic complications make it possible to maintain the spherical shape of the femoral head and good joint function. The results are considerably better than in untreated cases.