The progressive longitudinal traction reduction of unstable slipped capital femoral epiphysis: preliminary results in 11 patients.
OBJECTIVE
Unstable slipped capital femoral epiphysis is rare, but is frequently associated with avascular necrosis. The rapid and complete reduction of the epiphysis displacement was shown to be responsible for this complication. We present the preliminary results of a progressive reduction technique of epiphysis displacement.


METHODS
A total of 11 patients treated using progressive traction and internal fixation were reviewed retrospectively. Only children who underwent clinical and radiological follow-up for at least 18 months were included in this study to detect avascular necrosis.


RESULTS
The mean posterior displacement of the femoral head was 67 degrees and mean traction duration was 13 days. Of the patients, 2 had cutaneous problems requiring traction interruption, one on day 5 and the other on day 9. The mean residual slip was 16 degrees and 3 patients had complete or partial avascular necrosis well tolerated at the final follow-up.


CONCLUSIONS
Our experience showed that if traction is supported for more than 2 weeks, a good correction of the epiphysis displacement can be obtained. Our short series does not allow affirmation of the superiority of our therapeutic strategy, especially with regards to avascular necrosis of the femoral head.
Thomsen
Laurent
L
Armand Trousseau Hospital, Department of Paediatric Orthopaedics, Université Pierre et Marie Curie-Paris 6, 26, Avenue du Docteur Arnold Netter, Paris Cedex 12, 75571, France.
Vialle
Raphaël
R
Maillet
Marie
M
Mary
Pierre
P
Damsin
Jean-Paul
JP
Filipe
Georges
G