The timing of reduction and stabilisation of the acute, unstable, slipped upper femoral epiphysis

We reviewed the management of 100 cases of slipped upper femoral epiphysis treated over a period of 26 years. A total of 14 slips was identified as un stable on admission. These underwent reduction and stabilisation within 24 hours of the onset of severe symptoms. Of the 86 stable slips four progress ed to avascular necrosis (AVN), which was not seen in the unstable slips. T he literature on slipped upper femoral epiphysis suggests that the acute un stable slip is at higher risk of developing AVN. We recommend reduction and stabilisation of unstable slips within 24 hours of the onset of symptoms i n order to reduce the risk of AVN.