Slipped capital femoral epiphysis: Diagnostic pitfalls and therapeutic options


Published: 28 October 2022
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Authors

  • Elena Panuccio Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milano, Italy.
  • Daniele Priano Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milano, Italy.
  • Valerio Caccavella Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milano, Italy.
  • Antonio Memeo Department of Paediatric Orthopaedics and Traumatology, Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milano, Italy.

One of the most prevalent hip pathologies that develops during adolescence is Slipped Capital Femoral Epiphysis (SCFE), and over the past few decades, its incidence has been rising. To ensure an early diagnosis and prompt intervention, orthopedic surgeons should be aware of this entity. Review of recent developments in clinical examination and imaging diagnostic procedures. The presentation includes commonly used imaging methods, slippage measurement techniques, and classification schemes that are pertinent to treatment. An overview of SCFE surgery based on pertinent study findings and knowledge gained from ongoing clinical practice. The gold standard treatment for stable SCFE cases— those in which the continuity of the metaphysis and epiphysis is preserved—is pinning in situ using a single cannulated screw without reduction. However, there are disagreements over the best course of action for stable moderate/severe SCFE. On the best surgical strategy for unstable epiphysiolysis, no universal agreement has been reached. Finding the surgical procedure that will improve the long-term outcomes of a slipped capital femoral epiphysis is the question at hand.


Sucato DJ. Approach to the Hip for SCFE: The North American Perspective. J Pediatr Orthop 2018;38:S5–12. DOI: https://doi.org/10.1097/BPO.0000000000001183

Otani T, Kawaguchi Y, Marumo K. Diagnosis and treatment of slipped capital femoral epiphysis: Recent trends to note. J Orthop Sci 2018;23:220–8. DOI: https://doi.org/10.1016/j.jos.2017.12.009

de Poorter JJ, Beunder TJ, Gareb B, et al. Long-term outcomes of slipped capital femoral epiphysis treated with in situ pinning. J Child Orthop 2016;10:371–9. DOI: https://doi.org/10.1007/s11832-016-0759-z

Herrera-Soto JA, Duffy MF, Birnbaum MA, Vander Have KL. Increased intracapsular pressures after unstable slipped capital femoral epiphysis. J Pediatr Orthop 2008;28:723–8. DOI: https://doi.org/10.1097/BPO.0b013e318186bda3

Novais EN, Maranho DA, Heare T, et al. The modified Dunn procedure provides superior short-term outcomes in the treatment of the unstable slipped capital femoral epiphysis as compared to the inadvertent closed reduction and percutaneous pinning: a comparative clinical study. Int Orthop 2019;43:669–75. DOI: https://doi.org/10.1007/s00264-018-3993-9

Loder RT, Dietz FR. What is the best evidence for the treatment of slipped capital femoral epiphysis? J Pediatr Orthop 2012;32:S158–65. DOI: https://doi.org/10.1097/BPO.0b013e318259f2d1

Wylie JD, Novais EN. Evolving understanding of and treatment approaches to slipped capital femoral epiphysis. Curr Rev Musculoskelet Med 2019;12:213–9. DOI: https://doi.org/10.1007/s12178-019-09547-5

Kaushal N, Chen C, Agarwal KN, et al. Capsulotomy in unstable slipped capital femoral epiphysis and the odds of AVN: A meta-analysis of retrospective studies. J Pediatr Orthop 2019;39:e406–11. DOI: https://doi.org/10.1097/BPO.0000000000001359

Panuccio, E., Priano, D., Caccavella, V., & Memeo, A. (2022). Slipped capital femoral epiphysis: Diagnostic pitfalls and therapeutic options. La Pediatria Medica E Chirurgica, 44(s1). https://doi.org/10.4081/pmc.2022.296

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