Remodelling in slipped capital femoral epiphysis.

In-situ pinning of a slipped capital femoral epiphysis is the most common form of treatment for this problem. To find out if remodelling of the upper femur after pinning occurs often enough to justify this form of treatment and whether secondary osteotomies are required for residual deformity, 82 patients with slipped capital femoral epiphyses were reviewed. X-ray films were studied sequentially, noting remodelling changes in the femoral head and neck. Sixty-eight percent of moderate to severe slips that could be properly assessed showed signs of remodelling. The authors recognized two distinct remodelling processes--one, occurring early, affected the neck adjacent to the growth plate, the second appeared later, more distally along the femoral neck. Very few osteotomies were done for residual deformity. Pinning in situ of a slipped capital femoral epiphysis represents a simple, rapid and effective method of treatment, allowing remodelling even in more severe slips.