[Results of treating slipped capital femoral epiphysis by pinning in situ]. / Therapieergebnisse der In- situ-Spickung bei der Epiphyseolysis capitis femoris juvenilis lenta.

The primary aim in treatment of chronic SCFE consists of immediate stabilization of the epiphysis to prevent further slipping. For mild degrees of slipping (<30 degrees ), pinning in situ is the treatment of choice. With slips between 30 and 50 degrees, the decision should be based on individual factors (age, functional limitation of the hip joint) whether pinning in situ is sufficient or whether an additional intertrochanteric osteotomy according to Imhäuser should be performed.The choice of implant should ensure a safe and stable connection between the epiphysis and the femoral neck without resulting in a substantial impairment of growth of the femoral neck due to premature closure of the growth plate. Since 1982 we have used K wires for in situ pinning of the affected hip as well as for prophylactic pinning of the nonaffected hip with a low complication rate. In a clinical and radiological study, 65 patients with a chronic slip of less than 50 degrees could be assessed after in situ pinning. Almost 75% were pain-free after a follow-up interval of 9.8 years, and 92% achieved a good or very good result according to the criteria of the Iowa hip score, the mean score being 95.1 points. According to the radiological score of Schulitz, five patients (7.7%) demonstrated a grade I osteoarthritis. One patient showed a partial necrosis of the femoral head; chondrolysis was not observed.

[Living conditions and mortality in the elderly after surgical management of para-articular hip fractures]. / Lebensbedingungen und Letalität alter Menschen nach operativer Versorgung hüftnaher Oberschenkelbrüche.

While hemiendoprothesis has been established in the treatment of hip fractures of aged people because of less operative trauma, better effectiveness and satisfying functionality, surgical management of trochanteric fractures is still in discussion. In our study, we found no severe difference of living conditions or mortality after operating elderly patients with proximal femoral fractures comparing Hemiprotheses versus Endernails versus Dynamic Hip Screws.