Is Gentle Manipulative Reduction and Percutaneous Fixation with a Single Screw the Best Management of Acute and Acute-on-Chronic Slipped Capital Femoral Epiphysis? A Report of 70 Patients

Current practice in the management of acute/unstable slipped capital femoral epiphyses in the United Kingdom and the Netherlands: results of a survey of the membership of the British Society of Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie

“…In keeping with the literature, which demonstrates a tendency to operate percutaneously and use one screw fixation [3,4,12,[19][20][21][22][23][24], most of our respondents (79%) used a single screw. Interestingly, the use of a second screw was significantly higher in those surgeons with more experience.…”

“…De Sanctis [4] and Arnold [5] contradict Tokmakova [3]. They claim that preoperative reduction with very gentle manipulation and percutaneous fixation with a single screw [4] and K-wires [5], respectively, is the best treatment for acute SCFE and reduces the risk of AVN and chondrolysis.…”

Continued growth of the hip after fixation of slipped capital femoral epiphysis using a single cannulated screw with a proximal threading

“…Screw fixation seems to be associated with a lower complication rate [2,4,10,17,18]. Therefore, single-screw fixation is, at present, the most common [19].…”

Slipped upper femoral epiphysis

“…41 Clinical studies have repeatedly shown that single screw fixation yields satisfactory, if not superior, results to multiple pin or screw fixation for both stable and unstable slips. 42 Blanco et al 43 in a study of 114 hips treated with one two or three screws or pins, found that the incidence of pin-related complications was directly related the number of pins or screws (4.6% with one screw/pin, 19.6% with two and 36% with three).…”