A and B, Slipped capital femoral epiphysis. C, After pin fixation, several unnecessary drill holes remain distal to last pin. D, After pathologic fracture through drill hole. E, One year after open reduction and internal fixation with compression hip screw; note evidence of union of subtrochanteric fracture. Cannulated hip screw was left in place to prevent further slipping of capital femoral epiphysis at the time of hip screw insertion.