Pinning the slipped and contralateral hips in the treatment of slipped capital femoral epiphysis.

Abstract

To describe and comment on the treatment of the slipped capital femoral epiphysis (SCFE) with pinning and to present the pros and cons of prophylactic pinning of the contralateral hip. Pinning the SCFE aims to fix the epiphysis and prevent further slipping. Some devices allow for further growth and remodeling of the femoral neck post-operatively. This results in maintained femoral offset and probably reduced risk of femoroacetabular impingement. There are currently no long-term follow-up studies showing less complications or better function than after <i>in situ</i> fixation. The contralateral hip can be managed by prophylactic pinning or close follow-up with repeated radiographic examinations. Which of the methods is best is still controversial due to different opinions on the risk of bilateral SCFE, the consequences of a later contralateral slip and the risks of prophylactic pinning. Although research supports prophylactic pinning the child and the family's preference is crucial.