Controversies in the Management of Unstable Slipped Capital Femoral Epiphysis

Abstract

Slipped capital femoral epiphysis (SCFE) involves anterior-superior displacement of the proximal metaphysis relative to the epiphysis of the proximal femur. It is the most common hip disorder affecting the pediatric population. SCFE has a higher incidence in adolescent males in addition to racial and regional predilections. Despite being described over 500 years ago, there remains controversy surrounding the topic. This article examines current concepts in SCFE, with a spotlight on treatment. An evidence-based discussion of treatment controversies regarding reduction method, fixation construct, supplemental procedures and surgical timing is included.

Keywords: Avascular necrosis; Modified dunn osteotomy; Pediatric hip disorders; SCFE; Slipped capital femoral epiphysis; Unstable SCFE.