To test the traditional classification system of slipped capital femoral epiphysis, we evaluated the presenting symptoms and radiographs of 54 patients and reclassified the slipped epiphyses as unstable or stable, rather than acute, chronic, or acute-on-chronic. Slips were considered to be unstable when the patient had such severe pain that weight-bearing was not possible even with crutches. Slips were considered to be stable when the patient could bear weight, with or without crutches. We reviewed the records on 55 hips in which the slip would have been classified as acute because the duration of symptoms was less than 3 weeks; 30 of these were unstable and 25 were stable. All slips were treated with internal fixation. A reduction occurred in 26 of the unstable hips and in 2 of the stable hips. 14 (47 per cent) of the 30 unstable hips and 24 (96 per cent) of the 25 stable hips had a satisfactory result. Avascular necrosis developed in 14 (47 per cent) of the unstable hips and in none of the stable hips. We were not able to demonstrate an association between early reduction and the development of avascular necrosis.
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To test the traditional classification system of slipped capital femoral epiphysis, we evaluated the presenting symptoms and radiographs of 54 patients and reclassified the slipped epiphyses as unstable or stable, rather than acute, chronic, or acute-on-chronic. Slips were considered to be unstable when the patient had such severe pain that weight-bearing was not possible even with crutches. Slips were considered to be stable when the patient could bear weight, with or without crutches. We reviewed the records on 55 hips in which the slip would have been classified as acute because the duration of symptoms was less than 3 weeks; 30 of these were unstable and 25 were stable. All slips were treated with internal fixation. A reduction occurred in 26 of the unstable hips and in 2 of the stable hips. 14 (47 per cent) of the 30 unstable hips and 24 (96 per cent) of the 25 stable hips had a satisfactory result. Avascular necrosis developed in 14 (47 per cent) of the unstable hips and in none of the stable hips. We were not able to demonstrate an association between early reduction and the development of avascular necrosis.
Copyright remains with the authors and publisher.