title: Is gentle manipulative reduction and percutaneous fixation with a single screw the best management of acute and acute-on-chronic slipped capital femoral epiphysis? A report of 70 patients.
abstract: We report the results of the management of acute and acute-on-chronic slipped capital femoral epiphysis (SCFE) for 70 patients (81 hips) with an average follow-up of 6 years (range 1-15 years). We clinically reviewed 51 patients (55 hips) with acute or acute-on-chronic slip treated in our department from 1978 to 1993 with clinical and radiographic examination. Of these, 10 patients (11 hips) underwent a three-dimensional computed tomography (CT) scan to provide more details of the remodeling process. Percutaneous pinning with one cannulated screw appears to offer significant advantages. It is stable, safe, and reliable; there is no blood loss; the scar is small; hospital stay is brief; and early weightbearing is possible 2 weeks after the procedure, with low incidence of complications. Last, but not least, children can soon return to school. We conclude that preoperative reduction with very gentle manipulation and percutaneous pinning with a single screw is the best treatment for SCFE.
authors.affiliation: Department of Paediatric Orthopaedics and Traumatology, Santobono Children's Hospital, Naples, Italy.
authors.forename: N
authors.initials: N
authors.lastname: de Sanctis
authors.forename: G
authors.initials: G
authors.lastname: Di Gennaro
authors.forename: C
authors.initials: C
authors.lastname: Pempinello
authors.forename: S D
authors.initials: SD
authors.lastname: Corte
authors.forename: G
authors.initials: G
authors.lastname: Carannante
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001863:Bone Screws; D002648:Child; D002908:Chronic Disease; D004839:Epiphyses, Slipped / Q000000981:diagnostic imaging / Q000601:surgery*; D005069:Evaluation Studies as Topic; D005260:Female; D005270:Femur Head; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008349:Manipulation, Orthopedic; D009985:Orthopedics / Q000379:methods*; D011859:Radiography; D016059:Range of Motion, Articular; D016896:Treatment Outcome