Open bone peg epiphysiodesis for slipped capital femoral epiphysis

The records of 43 patients who underwent 64 open bone peg epiphysiodeses for slipped capital femoral epiphysis were retrospectively reviewed. There were 18 unstable and 46 stable slips. The average duration of follow-up was 35 months (range, 12-100). Healing occurred in all cases at an average of 17 weeks after surgery. At the time of healing, 27 hips (42%) showed a change in the degree of slip. At the most recent visit, the head-shaft angle had improved in 19 hips (30%), although the majority of hips showed resorption of the anterior neck prominence. The degree of remodeling showed no correlation with time to healing, duration of follow-up, or the status of the triradiate cartilage. The average operating time and blood loss per hip were 122 +/- 34 min and 426 +/- 238 ml, respectively. Complications included four hips with avascular necrosis and three with chondrolysis, three infections, four delayed wound healings, seven cases of transient anterolateral thigh hypesthesia, and 44 hips with hetertopic ossification. Because of the potential morbidity of this procedure, we no longer perform it as a primary operation for stable slipped capital femoral epiphysis.