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Chronic Slip


- Discussion:
    - most common presentation is chronic slip (60 % of cases);
    - may cause pain refered to hip, distal medial thigh, or knee;
    - on exam, look for loss internal rotation, which may be manifested by observing the extended hip move into external rotation as hip is flexed;
    - restricted abduction is found w/ severe slips;

- Radiographs:
       

- Treatment:
    - repositioning of epiphysis should not be attempted;
    - traction should be maintained before definitive treatment.
    - pin placement: in chronic slips, a single pin may prevent further slippage



 Natural history of untreated chronic slipped capital femoral epiphysis.

 Cuneiform osteotomy of the femoral neck in severe slipped capital femoral epiphysis.

 The treatment of chronic slipped capital femoral epiphysis by biplane osteotomy.

 Southwick osteotomy  for severe chronic slipped capital femoral epiphysis: results and complications.

 Cuneiform osteotomy of the femoral neck in the treatment of slipped capital femoral epiphysis. A follow-up note.

 Compensating osteotomy at the base of the femoral neck for slipped capital femoral epiphysis.

 Cuneiform osteotomy of the femoral neck in the treatment of slipped capital femoral epiphysis.

 Complications after cuneiform osteotomy for moderately or severely slipped capital femoral epiphysis.

 Double innominate osteotomy.