Effects of the grade, stability, chronological classification and being either unilateral or bilateral of the slip on the treatment by in situ single screw fixation of patients with slipped capital femoral epiphysis

Abstract

The effects of the grade, stability, chronological classification and being either unilateral or bilateral of the slip on the outcomes of the treatment by in situ single screw fixation of the Slipped capital femoral epiphysis were investigated. 34 hips of 24 patients (7 girls, 17 boys; mean age 12.04years; range 9-14; 14 slips acute, 7 slips acute on chronic, 13 slips chronic; 22 slips stable, 12 slips unstable; 20 slips Grade 1, 13 slips Grade 2, 1 slips Grade 3) between 2003 and 2009 were involved in the study. During the controls; range of motion, walking abnormalities, Trendelenburg test, use of assistive devices during mobilization, existence of pain and complications were evaluated. The evaluation of clinical results was made according to the average Harris Hip Score. 10 of 24 patients showed evidence of a slip of the contralateral hip on average 10.6 (6-16)months after the initial operation. At mean 41.52±8.08months controls, the Harris Hip Score was found 77.41±14.66, hip-joint motions, flexion 120° (70°-140°), abduction 40° (20°-60°), internal rotation 25° (10°-40°). Evaluation at the last follow-up showed significant differences between single hip slip than both hip slip, stable slip than unstable slip and Grade 1 slip than Grade 2 slip. In the last control of one patient with a Grade 3 slip, avascular necrosis has been observed. Considering the effect on the clinical results of the chronological classification of the no slip, significant differences have been seen between the clinical outcomes of the acute, chronic or acute on chronic slips. The outcomes of the treatment by in situ single screw fixation are negatively affected by increase in the grade of slip, instability of the slip and existence of slip at both hips.