Slipped capital femoral epiphysis is a common adolescent hip disorder and when patients present at an age younger than 10 years, it is atypical and there is often some identifiable associated metabolic or endocrinologic abnormality. We present the case of a 5-year-old boy with idiopathic bilateral slipped capital femoral epiphysis. This patient underwent staged bilateral pinning in situ using a uniquely modified screw where the distal threads were machined-off for smooth fixation across the physis. The patient had an unremarkable postoperative course and showed evidence of remodeling and patent physes at 1-year follow-up.

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