A retrospective study of 125 cases of slipped capital femoral epiphysis.

A series of 125 cases of slipped capital femoral epiphysis in 94 patients was followed an average of 4.7 years. Initial treatment consisted of closed reduction with internal fixation in 13 cases, cervical cuneiform osteotomy with internal fixation in nine, and in situ fixation in the remainder. The end-results were good in 82% of the cases. Of the nine failures, eight were due to avascular necrosis or chondrolysis. Closed reduction should be performed only in acute or acute-on-chronic slippings. Chronic slippings should be nailed in situ. The use of more involved procedures, such as cuneiform osteotomy, is not recommended because of the risk of avascular necrosis and because they do not allow the natural forces of remodeling to improve the deformity. Using this method, only three slippings required subsequent osteotomy.