Slipped Capital Femoral Epiphysis (SCFE) is a common paediatric disorder with documented racial predilection. No data exists regarding the Australian indigenous and Australian non-indigenous populations. This study provides a comprehensive demographic and epidemiologic analysis of SCFE in South Australia, with emphasis on establishing associations between increasing obesity and incidence.

A demographic review of all cases of SCFE managed in South Australian public hospitals between 1988 and 2007 was performed. Clinical presentation, surgical management and complication profile information was collected. Given that obesity is implicated in the biomechanical causation of SCFE due to increased shearing forces, particular emphasis was placed on gathering weight, race, gender and age data. A profile of the incidence and nature of SCFE was generated. Comparisons were then drawn between this profile and existing epidemiologic percentile data of weight, age and gender in South Australia.

A rising prevalence of obesity in South Australia corresponded with a rising incidence of SCFE. However, this relationship was not linear as the incidence of SCFE has doubled in the last 20 years and the average weight of SCFE patients has increased markedly.

The indigenous population was found to have higher rates of obesity than the non- indigenous population in South Australia. The indigenous population also has a relative risk of developing a SCFE of over three times the non-indigenous population.

The overall rate of complications in South Australian public hospitals was low, with avascular necrosis being recognised in our profile.

The rise in incidence of SCFE in South Australia; especially noticeable in the indigenous population is associated with an increasing prevalence of obesity. The considerable morbidity associated with SCFE was confirmed in our analysis and further highlights the importance of public health initiatives to tackle obesity in our community.

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.