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J Am Acad Orthop Surg, Vol 14, No 12, November 2006, 666-679.
© 2006 the American Academy of Orthopaedic Surgeons
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Slipped Capital Femoral Epiphysis: Current Concepts

David D. Aronsson, MD, Randall T. Loder, MD, Gert J. Breur, DVM, PhD and Stuart L. Weinstein, MD

Dr. Aronsson is Professor and Chief, Pediatric Orthopaedic Service, McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Burlington, VT. Dr. Loder is Garceau Professor of Pediatric Orthopaedics and Chief, Pediatric Orthopaedic Service, Riley Children’s Hospital, Indianapolis, IN. Dr. Breur is Associate Professor of Small Animal Orthopaedic and Neurosurgery, School of Veterinary Medicine, Purdue University, West Lafayette, IN. Dr. Weinstein is Ignacio V. Ponseti Chair and Professor of Orthopaedic Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Aronsson, Dr. Loder, Dr. Breur, and Dr. Weinstein.

Reprint requests: Dr. Aronsson, McClure Musculoskeletal Research Center, Department of Orthopaedics and Rehabilitation, University of Vermont College of Medicine, Robert T. Stafford Hall, Room 434B, Burlington, VT 05405.

Slipped capital femoral epiphysis is a common hip disorder in adolescents, with an incidence of 0.2 (Japan) to 10 (United States) per 100,000. The etiology is unknown, but biomechanical and biochemical factors play an important role. Symptoms at presentation include pain in the groin, thigh, or knee. Ambulatory patients also may present with a limp. Nonambulatory patients present with excruciating pain. The slipped capital femoral epiphysis is classified as stable when the patient can walk and unstable when the patient cannot walk, even with the aid of crutches. Because the epiphysis slips posteriorly, it is best seen on lateral radiographs. The treatment of choice for stable slipped capital femoral epiphysis is single-screw fixation in situ. This method has a high probability of long-term success, with minimal risk of complications. In the patient with unstable slipped capital femoral epiphysis, urgent hip joint aspiration followed by closed reduction and single- or double-screw fixation provides the best environment for a satisfactory result, while minimizing the risk of complications.






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Copyright © 2006 by the American Academy of Orthopaedic Surgeons.