Open reduction of slipped capital femoral epiphysis

The capital femoral epiphysis forms part of the ball‑and‑socket joint of the hip. In children and adolescents the ball and shaft of the femur are connected by a layer of soft cartilage, known as the growth plate, which allows for growth and hardens at adulthood. A slipped capital femoral epiphysis results in the displacement of the femoral head, usually posteriorly and inferiorly in relation to the femoral neck and within the confines of the acetabulum. This can cause knee or hip pain, limping and significant deformity.

Treatment options depend on the severity of the slip. Treatment of mild‑to‑moderate slips usually involves percutaneous in situ fixation, with or without prophylactic pinning of the contralateral hip using cannulated screws or Kirschner wires. For more severe acute slips, treatment options include open fixation of the growth plate using a bone graft combined with early intertrochanteric osteotomy to allow a full range of hip movement, or closed reduction and in situ fixation with cannulated screws or Kirschner wires.