PMC7276620_01
Hip and pelvis radiograph of the patient following his admittance. Standard hip and pelvis anteroposterior radiograph depicting the slippage of the left capital femoral epiphysis on the initial presentation of the patient at the accident and emergency department.
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F1
However, a radiograph revealed the existence of SCFE in the left hip (Fig. 1).
Magnetic resonance imaging scan of the patient following his admittance to our department.(a). Proton-density weighted image sequence-spectral attenuated inversion recovery coronal view. (b). T1-weighted image sequence coronal view (T1W). (c). mDIXON weighted sequence axial view. The slippage of the left capital femoral epiphysis seems to be milder following the application of a simple skin traction for a period of approximately 3 h.
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F2
A skin traction was put in place for analgesia and as a means to initiate- if possible- reduction of the fracture and the patient next underwent amagnetic resonance imaging (MRI)scan (Fig. 2), which confirmed the SCFE and excluded any other pathology.
Hip and pelvis radiographs intraoperatively taken.(a). C-arm intensifier hip and pelvis anteroposterior radiograph confirming the successful closed reduction of the slipped capital femoral epiphysis under general anesthesia. (b). A hip spicacast was applied following the reduction of the fracture.
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F3
Successful reduction was confirmed with the use of a c-arm image intensifier and a hip spicacast with an anti-rotation bar was applied next (Fig. 3).
Radiographs after the removal of the hip spicacast at 8 weeks following reduction. Hip and pelvis anteroposterior radiographs (a. Standard, b. Frogleg) after the removal of the hip spicacast at 8 weeks after the reduction of the slipped capital femoral epiphysis. The fracture has healed and the affected left epiphysis has the same size and shape as the contralateral. No signs of avascular necrosis or any other pathology can be identified.
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F4
The spicacast was removed at 8 weeks (Fig. 4).
Hip and pelvis radiographs 2 years after the reduction of the slipped capital femoral epiphysis (SCFE).Hip and pelvis anteroposterior radiographs (a and b. Standard, c. Abduction and external rotation) 2 years after the reduction of the SCFE. The left epiphysis has the same size and shape as the contralateral. No signs of avascular necrosis or any other pathology can be identified.
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F5
Consecutive follow-up radiographs obtained during the follow-up period, revealed good remodeling of the proximal femur and a femoral head with spherical contour and with no signs of avascular necrosis or chondrolysis (Fig. 5).
Magnetic resonance imaging scan at 24 months post-reduction. (a). T1W coronal view. (b). T2W coronal view. (c). ShortTI inversion recovery weighted image sequence coronal view. (d). T1W axial view. (e). T2W axial view. The fracture healed uneventfully, the affected left epiphysis has the same size and shape as the contralateral and no signs of avascular necrosis and/or any other complications are apparent.
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F6
An MRI scan at 2 years post-reduction showed normal shape and size of the affected femoral head, with no signs of physeal arrest and/or avascular necrosis (Fig. 6).