Surgical management of healed slipped capital femoral epiphysis

Abstract

Slipped capital femoral epiphysis (SCFE) results in posterior and inferior displacement of the epiphysis on the femoral neck. In most centers, the recommended initial management of stable SCFE is in situ pinning. Minimal reduction with in situ pinning is recommended for unstable SCFE. This approach does not restore the normal anatomy of the hip joint, and the resulting proximal femoral deformity may cause femoroacetabular impingement. Patients with femoroacetabular impingement experience reduced hip range of motion as well as hip pain, and they are at risk of early-onset hip osteoarthritis. Techniques for managing this deformity include arthroscopic femoral neck osteochondroplasty, a limited anterior hip approach or surgical hip dislocation, and flexion intertrochanteric osteotomy. These surgical techniques should be considered for patients with healed SCFE deformity who present with hip pain at an early age.