HIPEarly Reduction, Arthrotomy, and Cannulated Screw Fixation in Unstable Slipped Capital Femoral Epiphysis TreatmentGordon, J. Eric M.D.; Abrahams, Matthew S. B.S.; Dobbs, Matthew B. M.D.; Luhmann, Scott J. M.D.; Schoenecker, Perry L. M.D.Author Information Study conducted at St. Louis Shriners Hospital for Children and St. Louis Children's Hospital, St. Louis, Missouri, U.S.A. From the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis Shriners Hospital for Children, St. Louis, Missouri, U.S.A.; and St. Louis Children's Hospital, St. Louis, Missouri, U.S.A. Address correspondence and reprint requests to J. Eric Gordon, M.D., St. Louis Shriners Hospital for Children, 2001 South Lindbergh Boulevard, St. Louis, MO 63131, U.S.A. (e-mail: [email protected]). Journal of Pediatric Orthopaedics: May-June 2002 - Volume 22 - Issue 3 - p 352-358 Buy Abstract Sixteen consecutive cases of unstable slipped capital femoral epiphysis treated with urgent reduction and pinning during a 7-year period are presented. In 2 of the 16 patients, avascular necrosis of the femoral head developed. Ten of the 16 patients were treated within 24 hours after the onset of acute symptoms by reduction, arthrotomy, and cannulated screw fixation of the hip using two screws. In none of these patients did avascular necrosis of the femoral head develop. Two patients required hardware removal for persistent pain, and one required a revision pinning after a nondisplaced femoral neck fracture. Chondrolysis did not develop in any patient, and no hip progressed after fixation. At last follow-up (mean 27 months after surgery), two patients walked with a moderate limp. Three reported persistent mild pain in the affected hip. Early reduction of unstable hips with arthrotomy and pinning using two cannulated screws to minimize the risk of avascular necrosis is recommended. © 2002 Lippincott Williams & Wilkins, Inc.