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Slipped capital femoral epiphysis in skeletally immature patients

Orthopaedic Department, Children’s Hospital Gesù, Institute of Scientific, Research, Piazza S. Onofrio, 4, 00165 Rome, Italy.

C. L. Stanitski, MD, Professor of Orthopaedic Surgery

Children’s Hospital of the Medical University of South Carolina, Charleston, South Carolina 29425, USA.

Correspondence should be sent to Professor V. Guzzanti.

Fixation by a single screw is considered the current treatment of choice for a slipped capital femoral epiphysis. This approach promotes premature physeal closure. The use of a modified, standard, single, cannulated screw designed to maintain epiphyseal fixation without causing premature closure of the physis was reviewed in ten patients. The nine boys and one girl aged between 10.6 and 12.6 years with unilateral slipped capital femoral epiphysis (SCFE), were markedly skeletally immature (Tanner stage I, bone age 10 to 12.6 years).

Clinical and radiological review at a mean follow-up of 44.3 months (36 to 76) showed no difference in the time to physeal closure between the involved and uninvolved side. Measurement of epiphyseal and physeal development showed continued growth and remodelling in all patients.

Use of this device provided epiphyseal stability and maintained the capacity for physeal recovery and growth following treatment for both unstable and stable slipped capital femoral epiphysis.