Subcapital callus resection for slipped capital femoral epiphysis

Surgical Principles The lateral approach is routinely combined with an osteotomy of the greater trochanter. We resect the newly formed callus located at the anterior, posterior and caudal aspect of the femoral neck distal to the epiphysis. No shortening of the femoral neck results from this procedure. One can safely avoid a vascular injury by performing a careful dissection, since the posteriorly reflected articular capsule containing the nutrient vessels to the head is detached from the femoral neck like a banana peel. The resection manoeuvre is performed next to the physeal plate of the slipped epiphysis. After callus resection, reduction of the femoral head by longitudinal traction and internal rotation of the limb is easy. The aim is complete correction of the slippage. When there is excess physeal cartilage, we resect it with a curette and then the head is fixed using 2 screws. Revised Version from: Operat. Orthop. Traumatol. 4 (1992), 77–85 (German Edition).