Remodeling after in situ pinning for slipped capital femoral epiphysis]

We reviewed 61 hips in 50 children (33 boys and 17 girls) with slipped capital femoral epiphysis (SCFE), all treated by in situ pinning. Average age of our patients was 11.8 years (range, from 8 to 15 years). The average clinical and radiographic follow-up was 7.4 years. By studying the changes in physeal-shalt angle on radiographs in Lauenstein (frog) position, we found evidence of physeal remodeling in three (8%) of 38 mild and seven (30%) of 23 moderate slips. Remodeling of the proximal femoral metaphysis occurred in 92% of hips with a head-shaft angle less than 30 degrees and in 52% of hips between 30 degrees and 60 degrees. A process of local resorption and apposition of bone seems to be essential to final remodeling. The probability of remodeling was significantly less the greater the degree of slip, but was significantly increased among children 11 years old or younger and if the triradiate cartilage was open at the time of presentation. The range of internal rotation was significantly greater in those hips that remodeled. Pinning in situ of a slipped capital femoral epiphysis represents a simple, quick and effective method of treatment, allowing remodeling in mild and moderate slips.