Surgical Options in Slipped Capital Femoral Epiphysis

Slipped capital femoral epiphysis (SCFE) is a common disorder in the immature hip where the femoral metaphysis displaces anteriorly and superiorly with respect to the femoral epiphysis. In view of minimal operative trauma, low operative risk and the prospect of bone remodelling, fixation in situ with stabilisation of the capital physis without any attempt to reduce the slip is an established approach for the treatment of SCFE, particularly in cases of mild slips. However, some hips fail to reach the amount of remodelling needed for normal function, which puts those hips at risk for the development of femoro-acetabular impingement, labral and cartilage damage and eventually premature osteoarthritis. In this chapter, we present current trends in the clinical management of SCFE including conventional procedures as well as unique specialised surgical developments.