Treatment of slipped upper femoral epiphysis.

Slipping of the upper femoral epiphysis has been recognised since 1572 when it was first described by Pare, but its cause has not yet been fully determined. Treatment has been a controversial subject since the late nineteenth century when operative measures were first practised. The pendulum for and against operation has been swinging ever since, with a bias towards conservative treatment. The condition is relatively uncommon and therefore the collected results of a large series are valuable. After a study of slipped femoral epiphysis carried out by a sub-committee of the British Orthopaedic Association, Hall (1957) reported on the results of all forms of treatment in 173 hips in 138 patients representing a random sample ofthe results in the United Kingdom in recent years. The results of a previously unreported series of eighty-one hips in sixty-three patients are presented here (Table I). The series is comparable to Hall’s except that all hips have been compared with a standard of normal mobility of 85 (Gade’s indices). Although Gade produced an index of 100 for a normal hip Hall estimated it to be 90 in fifty normal hips and we found it to be 85. Assessment of functional activity followed Hall’s modification of Shepherd’s (1954) plan (Table II). The results in the series as a whole are comparable with those found by Hall (1957) (Table III, Fig. 1).