[Epiphysiolysis of the femoral head--can surgery prevent later arthritis?]

Slipped capital femoral epiphysis is one of the few orthopaedic emergencies. All orthopaedic surgeons agree that operation is the treatment of choice. In early stages, complete healing is possible. Fixation in situ is sufficient. If there is more severe dislocation of the head of the femur, the results become worse. More sophisticated and more difficult interventions aim at correction of the deformity, which may be a preliminary stage ['prearthrosis'] of osteoarthritis later in life. According to the extent of the slip, the surgeon may choose among different operations. The decision in a particular case is not easy. Complications are relatively frequent and sometimes severe. Long-term control show the late results and can thereby give guidelines for the surgeon's choice. Early diagnosis, however, is still decisive for a good prognosis in later life. As the disease is rather rare, the doctor who sees the patient first must be aware of it. Even at an early stage diagnosis can always be made on the basis of history, clinical findings and two X-rays.