Slipped capital femoral epiphysis: a population-based study

Abstract

BackgroundSlipped capital femoral epiphysis (SCFE) is the most common hip disorder in children 9–15 years old. This is a population-based study in Sweden presenting the epidemiology for SCFE.MethodsIn a prospective cohort study, we analysed pre- and postoperative radiographs, medical records for all children treated for SCFE in Sweden 2007–2013, demographic data, severity of slip and surgical procedures performed.ResultsWe identified 379 Swedish children with primary SCFE 2007–2013; 162 girls, median age 11.7 (7.2–15.4) years, and 217 boys, median age 13 (3.8–17.7) years. The average annual incidence was 4.4/10000 for girls and 5.7/10000 for boys 9–15 years old. Obesity or overweight was found in 56% of the girls and in 76% of the boys. As an initial symptom, 66% of the children had hip/groin pain and 12% knee pain. At first presentation, 7% of the children had bilateral SCFE. Prophylactic fixation was performed in 43%. Of the remaining children, 21% later developed a contralateral slip.Fixation with implants permitting further growth was used in >90% of the children. Femoral neck osteotomy was performed for 11 hips.ConclusionsThe annual average incidence 2007–2013 in Sweden showed a mild increase for girls. The male-to-female ratio was lower than previous regional data from Sweden. Overweight or obesity is one major characteristic for boys with SCFE but to a less extent for girls. Knee pain as initial symptom cause a delay in diagnosis. Most hospitals in Sweden treat <2 children annually.

Avaliação do ângulo de Southwick em duzentos quadris de crianças e adolescentes assintomáticos

“…4,10,11 The prevalence of proximal femoral epiphysiolysis, depending on the region of the world and on ethnicity, varies on average from 2 to 10 for every 100,000 susceptible individuals. [12][13][14] Studies indicate that this disease is more common in boys 7 and young black individuals, 15 with a greater dominance on the left side. 4,5,7,13,14 The diagnosis of proximal femoral epiphysiolysis is confirmed by simple radiographs in anteroposterior (AP) projection of the pelvis in the frog-leg position or double abduction (Lowenstein), in which, even before the displacement of the epiphysis in relation to the cervix, an increase at the height or thickness of the growth plate and a reduction in the projection of the mammillary bodies can be detected.…”

“…[12][13][14] Studies indicate that this disease is more common in boys 7 and young black individuals, 15 with a greater dominance on the left side. 4,5,7,13,14 The diagnosis of proximal femoral epiphysiolysis is confirmed by simple radiographs in anteroposterior (AP) projection of the pelvis in the frog-leg position or double abduction (Lowenstein), in which, even before the displacement of the epiphysis in relation to the cervix, an increase at the height or thickness of the growth plate and a reduction in the projection of the mammillary bodies can be detected. 16 On AP radiographs, a line traced in the upper portion of the femoral neck should cross part of the epiphyseal nucleus (Trethowan sign) and, when it does not, this suggests the presence of slippage.…”

A novel surgical navigation technology for placement of implants in slipped capital femoral epiphysis

“…Hip deformity in adolescence is common and a known precursor to adult hip pathology. One of the most common adolescent hip conditions is slipped capital femoral epiphysis (SCFE), whereby the proximal femoral epiphysis shifts into a varus malalignment through the proximal femoral physis, with an estimated prevalence of 1 to 10 per 100 000 children (Figure 1A). Given the resultant hip malalignment seen in patients with SCFE, this condition is thought to be a factor in up to 25% of degenerative hip disease in adults requiring total hip arthroplasty .…”

Persisting CAM deformity is associated with early cartilage degeneration after Slipped Capital Femoral Epiphysis: 11-year follow-up including dGEMRIC

“…Slipped Capital Femoral Epiphysis (SCFE) is the most common adolescent hip disorder affecting approximately 5/10,000 children in Sweden 1,2 , usually between 9 and 16 years of age. In the majority of cases, the disorder is treated surgically by introducing a nail or screw from the lateral aspect of the proximal femur into the femoral head (the epiphysis) in order to prevent further slippage.…”