Thirteen patients who had seventeen slipped capital femoral epiphyses
were managed with a spica cast between 1984 and 1986. The average time in
the plaster cast was three months. Complications were noted in fourteen of
the hips. Three pressure sores developed in two patients. Further slipping
developed in three hips once the cast had been removed, and chondrolysis
developed in one of these hips. Chondrolysis developed in eight additional
hips, and the lesion was transient in four of them. Degenerative changes
developed in all nine hips with chondrolysis, regardless of whether the
chondrolysis was transient or permanent. The degenerative changes were Iowa
Grade I in three of these hips, Grade II in two hips, and Grade III in
four. Chondrolysis developed in six of the eight black patients and in four
of the five black boys. Chondrolysis developed in six of the nine hips that
had a Grade-II or III slip. These findings have led us to abandon the use
of a spica cast as a mode of treatment for slipped capital femoral
epiphysis.