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February 14, 1948


JAMA. 1948;136(7):445-451. doi:10.1001/jama.1948.02890240011004

The treatment of epiphysiolysis or slipped capital femoral epiphysis at the Massachusetts General Hospital, since our report in 1943, has been standardized in conformity with our conclusions reported then.1 Patients with pronounced slipping of the epiphysis have been treated by arthrotomy, reposition of the displaced epiphysis on the neck and fixation by means of a three-flanged nail. Patients with only a minimal slipping of the epiphysis have been treated by lateral nailing in situ, without arthrotomy and without correction of the early deformity.

Any child 9 to 16 years of age, who complains of limp and/or pain in the region of the hip, anterior part of the thigh or the knee is suspected of having a slipped epiphysis. Examination may reveal that he walks with the involved limb in external rotation. On flexion of the hip, this external rotation may be increased or there may be only a slight