The Journal of Bone and Joint Surgery, Vol 68, Issue 7 1000-1007, Copyright © 1986 by Journal of Bone and Joint Surgery, Inc
The association of femoral retroversion with slipped capital femoral epiphysis
RH Gelberman, MS Cohen, BA Shaw, JR Kasser, PP Griffin and RH Wilkinson
We examined twenty-five patients who had a unilateral or bilateral slip of
the capital femoral epiphysis and determined the degree of anteversion of
the thirty-nine involved hips with computerized axial tomography. Thirteen
patients (eighteen hips) were seen at the time of the original diagnosis
(Group I), and twelve patients (twenty-one hips) were seen one to seven
years after operative treatment (Group II). The mean amount of anteversion
for all of the involved hips was +1.0 +/- 8.2 degrees. The mean amount of
anteversion for the Group-I hips was -0.7 +/- 7.4 degrees and the mean
amount for the Group-II hips was 2.5 +/- 8.7 degrees. The mean amount of
anteversion for the hips in both Groups I and II was less than the
predicted mean amount for individuals of the same age. The mean amount of
anteversion of the unaffected hips of our patients who had a unilateral
slip was +6.3 +/- 8.2 degrees. The amount of internal rotation of the hip
in extension exceeded the amount when it was in flexion in all of the
patients. A decreased angle of femoral anteversion appears to be
specifically associated with the development of slipped capital femoral
epiphysis. The mechanical forces that act across the proximal femoral
physis may be altered by this rotational abnormality, and this may lead to
an increased shear stress that ultimately causes failure of the growth
plate.
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