Slipped Capital Femoral Epiphysis – Initial Results of Treatment with Fixclips,a Modification of Kirschner Wire Fixation

Abstract

26 cases (21 patients) with Slipped Upper Femoral Epiphysis were treated by internal fixation with Fixclips. Of the 19 males and two females with a mean age of 12 l/2 years (range 10–15), 22 were fixed in situ and 4 required Dunn's osteotomies. The Fixclip allows two 2mm K wires, transfixing the proximal femoral epiphysis, to be anchored to the lateral femoral cortex. Post-operatively partial weight bearing was commenced at 6 weeks. The mean follow-up was 17 months (range 8–26), 10 cases being followed up to epiphyseal union. There were no failures of fixation and no significant complications.

Given that the size of implant used to treat slipped femoral epiphyses may be related to the chance of developing avascular necrosis, the small cross sectional area of simple K wires offers a potential advantage. The Fixclip prevents K wire penetration or extrusion, previously a problem with this type of fixation. In addition, ease of removal offers a significant advantage given the inevitability that a proportion of these patients will outgrow their primary fixation and require revision of fixation.