Slipped capital femoral epiphysis: evaluation of different modes of treatment.

We reviewed 91 hips with slipped capital femoral epiphysis (SCFE) after an average follow-up period of 6 years 6 months. Different treatment methods used, according to types and stages of slipping, are discussed. In situ fixation appears to be the best procedure for SCFE with < 60% displacement. Careful reduction-fixation is indicated in acute and acute-on-chronic SCFE > 60%. Primary rotation osteotomies are associated with a high percentage of complications. Secondary osteotomies should be simple (preferably a subtrochanteric derotation osteotomy) to reduce the risk of necrosis. Preventive contralateral fixation is indicated when the growth cartilage is still open.