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Treatment of slipped capital femoral epiphysis - a comparative study during twelve years period

Bukva Bojan (University Children`s Hospital, Department of Pediatric Orthopaedic Surgery, Belgrade)
Dučić Siniša (University Children`s Hospital, Department of Pediatric Orthopaedic Surgery, Belgrade)
Radlović Vladimir (University Children`s Hospital, Department of Pediatric Orthopaedic Surgery, Belgrade)
Vrgoč Goran (Sveti Duh University Hospital, Department of Orthopaedic Surgery, Zagreb, Croatia)
Krivokapić Branislav (Banjica Institute for Orthopaedic Surgery, Belgrade)
Jelaska Igor (University of Split, Faculty of Kinesiology, Split, Croatia)
Mandić-Jelaska Petra (University of Split, Faculty of Kinesiology, Split, Croatia)

Introduction/Objective. The purpose of this study was to compare two methods of treatment and to evaluate the advantages in the final outcome of transcervical fixation of the femoral head using one cannulated screw in the treatment of slipped capital femoral epiphysis. Methods. This study included 65 pediatric patients (35 boys and 30 girls), aged 6–16 years (average 11.86), during a 12-year period (2000–2012). We compared the slipping degree before and after the treatment (Southwick angle), the range of motion before and after treatment, and complication occurrence between two groups of children. The first group of children (26 patients) underwent closed reduction and cast immobilization (Group I). The other group (39 patients) was treated with transcervical fixation using one cannulated screw (Group II). Results. Comparing preoperative and postoperative Southwick angle, we found much better improvement in Group II, but without statistical significance between the two groups of patients (p = 0.09). Observing the range of motion of the hips before and after treatment, we found improvement in both groups of patients, especially in patients treated using transcervical fixation with cannulated screw (Group II). In complication occurrence, the patients in Group II had less complication occurrence compared to Group I (p = 0.02). Conclusion. The transcervical fixation using one cannulated screw has better clinical outcome and lower complication rate in relation to closed reduction and cast immobilization in the treatment of slipped capital femoral epiphysis.

Keywords: transcervical fixation, cannulated screw, closed reduction