with a transcervical fracture – closed reduction and internal fixation. The Delbert classification goes from I to IV with A and B suffixes to indicate if the head is reduced or dislocated (A = dislocated, B = reduced). So the classification is:
I – transphyseal (with head dislocated (IA) or head reduced (IB))
II – transcervical (with head dislocated (IA) or head reduced (IB))
III – basicervical (with head dislocated (IA) or head reduced (IB))
IV – intertrochanteric (with head dislocated (IA) or head reduced (IB))
– if you can, stop the internal fixation short of the physis. The intertroch’s are often treated with traction then spica casting, but in an 8 year old or unstable fracture or multitrauma – consider fixing.
– in a kid with SCFE with a 50 degree head-neck shaft angle on the AP and a 30 degree head-neck shaft angle on the lateral (Southwick angles), there would be an obligatory external rotation deformity in flexion, a varus hip and limp, and a decrease in internal rotation. A 30-50 degree slip on the lateral is considered to be a mild slip (normal is