"Recurrent" slipped capital femoral epiphysis the necessity of simultaneous stabilization of both epiphyseal plates

In the operative therapy of slipped capital femoral epiphysis, a controvers ial discussion exists about the sense of a simultaneous stabilization of bo th epiphyseal plates and about the correct time of removing the implants. We show the epikrisis of two patients to demonstrate our therapy regimen: i n the first case the implants were removed too early. The consequence was a further slipping of the femoral epiphysis consecutive on both sides and th e necessity of further surgery. In the other case we observed an outgrowing of the implant out of the epiphyseal plate by use of unthreaded wires. The growth plate was not closed. The femoral epiphysis was stabilized again, b ecause an outgrowing compares to an implant removal at a too early stage. These two cases show our point of view. We recommend to stabilize both side s simultaneously with threaded wires and not to remove the implants before closure of the epiphyseal plate. Furthermore, we hold it advisable to perfo rm a restabilization, when the implants grow out of the unclosed epiphyseal plate during adolescence.