Slipped capital femoral epiphysis. An assessment of treatment modalities.

Fifty-five patients underwent operative treatment of slipped capital femoral epiphyses at Children's Hospital Medical Center in Cincinnati, Ohio, between January 1975 and April 1980. Charts and x-rays were available for review in 45 of these patients with 68 affected hips; the incidence of bilaterality was 51%. Sixty-five of the 68 hips were managed by pinning. Problems with pin placement were recognized in 15.4% of these hips. Three patients were treated by subtrochanteric osteotomy, without complications. Since May 1980, all patients treated on the University Service, Children's Hospital Medical Center for slipped capital femoral epiphysis have undergone open epiphysiodesis utilizing a cosmetic "bikini" incision. Twenty-two hips in 14 patients were so managed without significant complications. This should be considered the treatment of choice for slips involving change greater than 30 degrees in the head shaft angle.