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Children's Orthopaedics

EPIDEMIOLOGY OF SLIPPED CAPITAL FEMORAL EPIPHYSIS IN SWEDEN: A TOTAL POPULATION STUDY

The British Society for Children' s Orthopaedic Surgery (BSCOS) and the Swedish Paediatric Orthopaedic Society (SBOF), Combined Meeting, March 2017



Abstract

Purpose

Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in children 9–15 years old. The epidemiology for SCFE in the total population of Sweden has not yet been described.

Methods

In a prospective cohort study, we analysed pre- and postoperative radiographs and medical records for all children treated for SCFE in Sweden 2007–2013, and noted demographic data, severity of slip, and surgical procedures performed.

Results

We identified 379 Swedish children with primary SCFE 2007–2013; 162 girls, median age 12 (7–15) years, and 217 boys, median age 13 (4–17) years. The cumulative incidence was 45.8/100 000 for girls and 58.2/100 000 for 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 of the femoral neck was used in 90% of the children. Femoral neck osteotomy was performed for 11 hips. Of 34 treating hospitals, only three treated > 3 children with SCFE annually.

Conclusions

The cumulative incidence 2007–2013 in the total population in Sweden showed a mild increase for girls. The male-to-female ratio was lower than previously described for Sweden. Prophylactic fixation was performed in 43% of the children. Fixation with an implant that allows further growth was used for 90% of the children. Most hospitals in Sweden treat < 2 children annually.