[Acute slipped femur head epiphysis. Causes--surgical treatment--results]

The juvenile slipped capital femoral epiphysis depends on a dysendocrinia during puberal acceleration. The weakening of mechanical stability of the epiphyseal cartilage leads in most of the cases to a slow, only in some cases to an acute dorsocaudal slipping of the capital femoral epiphysis. Representation of our own patients of Orthopedic University Hospital D-Homburg/Saar with altogether 27 acute slipped capital femoral epiphyses during the years 1965-1981. The early operative stabilisation seems to be most important for a good prognosis (danger of development of femoral head necrosis). The opening of the hip joint during the operation by a ventral capsulotomy facilitates the reduction and decompresses the haematoma. In consideration of the mostly slow beginning, in many cases an ideal correction could not be achieved in most of the patients. In contrast to the osteosynthesis by screws the growth in length is less influenced by using a lamellar nail or Kirschner-wires. In cases of an acute slipped capital femoral epiphysis a first conservative treatment with subsequent correction osteotomy does not seem to be justifiable, because the danger of femoral head necrosis raises drastically. In case of opportune operation and correct technique good to fair functional results can be achieved.