Abstract
Introduction: Slipped Capital Femoral Epiphysis (SCFE) is the most common hip problem of adolescence. Obesity and African and Pacific Islander races have been associated with increased susceptibility. In the setting of increasing rates of obesity in Australian adolescents over the last twenty years, it is unknown whether the incidence of this condition is increasing. There are no studies to date on the Australian population and it is unknown whether there is an increased incidence in the local Aboriginal population.
Aims: The demographics of SCFE patients presenting to the Women’s and Children’s Hospital (W& CH) in Adelaide were studied, from 1988 to the present, with particular emphasis on weight and race. This was then compared to weight for age percentiles data in the Australian population. The issues of prophylactic pinning of the contralateral side and the efficacy of the department protocol of “pinning in situ” were also studied.
Method: Systematic chart review, statistical analysis, and comparison with data from the Australian Bureau of Statistics and the Centre for Applied Anthropometry, University of South Australia, pertaining to weight and racial mix in South Australia.
Results: SCFE was associated with obesity. Over 45% of the cohort was above the 95th percentile for weight. The mean weight was in the 85th percentile and the median weight was in the 94th percentile.
As an example, the average weight of children aged 12 to 14 years was 13kgs more than the median value of children in this age group.
There was a clear increase in incidence of this condition over the last twenty years which corresponds with increasing obesity rates in the community.
There was a higher incidence in the indigenous population as compared with the non-indigenous population.
Out of the 236 patients enrolled, 5 cases were complicated by avascular necrosis. The overall complication rate was low.
Rate of progression to contralateral slip was low as was the rate of prophylactic pinning.
Conclusions: Our complication rate when compared to other centres is relatively low and would seem to support our consistent protocol of “pinning in situ”. The low rate of progression to contralateral slip also supports our protocol of watchful surveillance rather than mandatory prophylactic pinning of the contralateral side.
We have shown that SCFE is associated with obesity in Australia when compared with general population data. Obesity is also more common in the Aboriginal population and we postulate that this explains the higher incidence of SCFE in this group. In keeping with increasing rates of obesity amongst Australian adolescents, the increasing incidence of this condition further highlights the importance of public health initiatives to tackle obesity in the community.
The abstracts were prepared by David AF Morgan. Correspondence should be addressed to him at davidafmorgan@aoa.org.au
Declaration of interest: a
