In situ fixation of the slipped capital femoral epiphysis with a single screw

We made a retrospective analysis of a consecutive series of patients with slipped capital femoral epiphyses (SCFE) surgically treated at the Shriners Hospitals for Crippled Children at Lexington, Kentucky. The clinical outcome was correlated to the number of pins and the incidence of chondrolysis, ischemic necrosis, and progressive slipping after the initial fixation. An evaluation made of the Walters-Simon theoretic pin penetration formula was of no value in this series. We compiled results in the medical literature and compared them with ours; all information indicated that a single pin through an anterior portal significantly reduces complications and provides reliable fixation. However, ischemic necrosis still occurs in the unstable dip, although at a lesser rate than in cases treated with multiple pin fixation.