Abstract
Aim
To inform a working group of UK paediatric surgeons (the UK SCFE Study Group) convened to design pertinent trials in slipped capital femoral epiphysis (SCFE), three centres (Bristol, Newcastle and Barts and The London) reviewed the demographics and management of children with SCFE presenting between 2007 and 2012.
Method
At all contributing centres with digital PACS records for a minimum of 5 years, a search for the following terms was made of PACS reports: slipped capital femoral epiphysis, slipped upper femoral epiphysis, SCFE and SUFE. From the results, radiographs and electronically stored clinic letters were assessed to confirm the diagnosis and ascertain age at presentation, incidence of bilaterality, chronicity, stability (Loder criteria), management and complications.
Results
A total of 134 SCFEs presented between 2007 and 2012 to the three units. The mean age at presentation was 12.8 yrs (range 6–16 yrs). There were 91 males and 43 females. The left hip was nearly twice as commonly involved compared to the right, with bilateral presentation in 26.5% of patients. The most common mode of presentation was acute-on-chronic. Stable slips were over twice as common as unstable. The most common intervention was percutaneous pinning in situ. Open reduction, osteotomy and stabilisation were required in 21% of cases. The most common complications were osteonecrosis (n=17), screw migration/penetration (n=9), leg length discrepancy (n=9) and symptomatic secondary cam with femoroacetabular impingement (n=7).
Conclusion
This three-centre UK study gives insight into the demographics and contemporary management of SCFE, acts as a guide to larger audits of current practice throughout the UK and informs the subject and content of potential future randomised clinical trials.
