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The asymptomatic contralateral hip in unilateral slipped capital femoral epiphysis: morbidity of prophylactic fixation

Woelfle, Julia V.; Fraitzl, Christian R.; Reichel, Heiko; Nelitz, Manfred

Journal of Pediatric Orthopaedics B: May 2012 - Volume 21 - Issue 3 - p 226–229
doi: 10.1097/BPB.0b013e3283524bae

Prophylactic contralateral fixation in unilateral slipped capital femoral epiphysis (SCFE) remains a controversial issue. In this study, 66 patients treated for unilateral SCFE (July 1997–April 2009) were screened for complications with need for surgical reintervention in the asymptomatic contralateral hip. Except for one patient, prophylactic fixation was performed in all cases. Major complications such as avascular necrosis were not seen; minor complications such as wound revision occurred in 4.6% (three of 65). In 16.9% (11/65) secondary loss of fixation with need for second fixation occurred. As the need for second fixation arose mostly bilaterally (10.7%, 7/65), only four patients (6.2%) required an additional surgical procedure for second fixation. Children who needed second fixation were significantly younger (11.8 years) than those who did not (13.1 years, P=0.013). In conclusion, this retrospective analysis shows that prophylactic contralateral fixation in SCFE is a safe procedure with no major complications and an acceptable rate of minor complications. When Kirschner wires are used for prophylactic pinning, there is a possibility of secondary loss of fixation due to length growth at the level of the physis. To avoid the need for secondary fixation, screw epiphysiodesis might be considered.

Department of Orthopaedic Surgery, University of Ulm, Ulm Germany

Correspondence to Julia V. Woelfle, Department of Orthopaedic Surgery, University of Ulm, RKU, Oberer Eselsberg 45, 89081 Ulm, Germany Tel: +49 731 177 5118; fax: +49 731 177 1103; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.