Chronic slipped capital femoral epiphysis: Treatment by pinning in situ

Chronic or stable slipped capital femoral epiphysis (SCFE) is a lesion of the hip, affecting the adolescent patient through adulthood. The change in the shape of the femoral head and to the biomechanics of the hip joint leads to early osteoarthritis. Treatment of SCFE is designed to stop slip progression to reduce the degree of osteoarthritis. Complications, such as avascular necrosis and chondrolysis, may also cause osteoarthritis. In situ pinning of SCFE is considered the best treatment modality currently available. In situ pinning of SCFE has the advantages of effectiveness, low morbidity, and a low complication rate. These advantages outweigh the disadvantage of fusing the slip in the uncorrected position. The authors review the indications, the techniques of in situ pinning, the results, and the complications of the procedure. The technique of in situ pinning necessitates experience and understanding of the anatomy of the adolescent hip, as well as adequate imaging equipment.