Slipping of the femoral capital epiphysis (SFCE) has recently become more commonplace in Japan. Figure 1 shows a patient with SFCE who was treated in the 1960s in Niigata University Hospital. At that time, manual reduction followed by pinning was common in Japan. However, by the age of 31, a severe arthritic change occurred in this patient.

Authors [3,4,5] reviewed the cases in the hospitals associated with Niigata University and found that of five cases that underwent manual reduction, unfortunately four of them had femoral head necrosis, which resulted in osteoarthritic change at an early age. Therefore, forceful reduction is contraindicated.

The aim of the treatment for SFCE is first to improve joint incongruity and correct the range of motion (ROM) without complications. This procedure will prevent the development of osteoarthritis in the hip joint. With these points in mind, we chose Imhaeuser's method and treated the patients according to his principles. This chapter is the report of the treatment of those patients along with their long-term follow-up.

1 Department of Orthopaedic Surgery, Nakajo Central Hospital, 12-1 Nishihoncho, Tainai, 959-2656 Niigata, Japan

2 Division of Orthopaedic Surgery, Department of Regenerative and Transplant Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan

Fig. 1. A A 14-year-old boy, posterior tilt 65°. B Manual reduction and pinning. C Osteoarthritic change after femoral head necrosis at the age of 31 years old

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