Percutaneous osteotomy for deformity correction in adolescents with severe slipped capital femoral epiphysis

Various methods of performing proximal femoral realignment in adolescents with severe slipped capital femoral epiphysis exist. We report the technique and early results of a percutaneous, opening wedge subtrochanteric femoral osteotomy using an external fixator for correcting multiplanar deformities in such patients. Nine adolescents with severe slipped capital femoral epiphysis underwent a percutaneous osteotomy at an average age of 14.5 years. Mean operative blood loss was 61 ml, with 2 days of inpatient stay and 129 days of external fixation time. At an average follow-up of 23 months, hip flexion improved from 74 to 1068, internal rotation from -5 to + 17 degrees, external rotation from 71 to 418 and abduction from 29 to 36 degrees. Radiographs revealed an improvement in anteroposterior head shaft angle from 112 to 1348 and lateral head shaft angle from 72 to 15 degrees. One patient had transient chondrolysis. No fixation-related problems, deep infection, avascular necrosis or refracture occurred. On the basis of our preliminary results, this percutaneous technique offers several advantages over currently available methods for surgical correction of severe slipped capital femoral epiphysis deformities. J Pediatr Orthop B 15: 396-403 (C) 2006 Lippincott Williams & Wilkins.