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Journal of Bone and Joint Surgery - British Volume, Vol 88-B, Issue 11, 1497-1501.
doi: 10.1302/0301-620X.88B11.17523  
Copyright © 2006 by British Editorial Society of Bone and Joint Surgery
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The contralateral slip

AN AVOIDABLE COMPLICATION AND INDICATION FOR PROPHYLACTIC PINNING IN SLIPPED UPPER FEMORAL EPIPHYSIS

J. G. B. MacLean, FRCS(Orth), Consultant Orthopaedic Surgeon1; and S. K. Reddy, FRCS(Orth), MCh(Orth), Specialist Orthopaedic Registrar2

1 Department of Orthopaedics, Perth Royal Infirmary, Taymount Terrace, Perth PH1 1NX, UK.
2 Department of Orthopaedics Ninewells Hospital, Dundee DD1 9SY, UK.

Correspondence should be sent to Mr J. G. B. MacLean; e-mail: Jamie.maclean{at}tuht.scot.nhs.uk

Between July 1994 and June 2004, 60 patients with 76 slipped upper femoral epiphyses were managed within the adult trauma service of three hospitals. Treatment was by a single cannulated screw.

Of these cases, 53 were unilateral, in 17 of which uncomplicated prophylactic fixation of the contralateral hip was performed. Of the other 36 cases, nine presented with a subsequent slip despite ongoing out-patient care. The subsequent slip was unpredictable in timing and unrelated to the age at the initial slip. It was more often unstable and in one case avascular necrosis developed. The overall rate of avascular necrosis, although in accordance with the literature, was 60% in acute unstable slips with a slip angle greater than 40°.

In our experience, prophylactic fixation was safer than continued observation of the contralateral hip.




eLetters:

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Is prophylactic contralateral pinning in unilateral slipped upper femoral epiphysis justified?
Prof. Zoran S Vukasinovic, et al.
J Bone Joint Surg Br Online, 9 Nov 2006 [Full text]

(c) British Editorial Society of Bone and Joint Surgery All Rights Reserved
Registered charity no: 209299     Print ISSN: 0301-620X
Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General