Treatment of slipped capital femoral epiphysis. Spica-cast immobilization.
Thirty-two patients (thirty-seven hips) who had a so-called acute-on-chronic or chronic slipped capital femoral epiphysis were treated with traction for relief of symptoms and then with immobilization in a spica cast for eight to sixteen weeks. The disappearance on radiographs of a metaphyseal juxtaphyseal radiolucency, rather than closure of the physis, was used as the criterion for removing the cast. In one (3 per cent) of the thirty-seven hips, the slip progressed; possibly this could have been prevented by keeping the cast on for a longer period of time. Narrowing of the cartilage space was seen after treatment in a cast in seven (19 per cent) of the thirty-seven hips. In five of these seven hips, this was true chondrolysis; in one, the diagnosis of chondrolysis had been apparent before treatment. Avascular necrosis did not develop as a result of treatment in any patient. Treatment in a spica cast should be considered as an alternative for patients who have an acute-on-chronic or chronic slipped capital femoral epiphysis.
Betz
R R
RR
Shriners Hospitals for Crippled Children, Philadelphia, Pennsylvania 19152.
Steel
H H
HH
Emper
W D
WD
Huss
G K
GK
Clancy
M
M
D000293:Adolescent; D002370:Casts, Surgical; D002648:Child; D004839:Epiphyses, Slipped / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D007103:Immobilization; D008297:Male; D011859:Radiography