Pinning in slipped capital femoral epiphysis: long-term follow-up study.

Abstract

This long-term follow-up study was aimed at evaluating patients with hip epiphysiolysis treated by pinning and previously controlled by short-term follow-up, in order to evaluate both clinical and radiographic evolution. The case series included 36 patients (17 female and 19 male) for overall 48 hips (21 right, 27 left). The epiphysiolysis was bilateral in 12 patients. Median follow-up was 17.9 years (range 8.8-29.2). Clinical results were evaluated according to Harris, radiographic results according to Boyer. The patients were divided into three groups according to slipping degree calculated following Southwick (0-30 degrees, 30-60 degrees, >60 degrees ). Slipping degree was found to be directly correlated with worsening of results. Reduction manoeuvres on chronic epiphysiolysis proved to lead to even poorer results. Our review, even though carried out on a limited number of cases, showed that (1) hips with arthrosis at first control resulted in worsening in the majority of cases; (2) slipping degree was proportional to the result obtained; (3) reduction manoeuvres performed on chronic epiphysiolysis had a negative influence on results; (4) the presence of chondrolysis or epiphyseal necrosis always led to early hip arthrosis; (5) in the absence of major complications, evolution towards arthrosis can be slow and adulthood or even old age can be reached without resorting to total hip replacement.