Optimal Timing of Operative Fixation for Slipped Capital Femoral Epiphysis

Alexander B White
Slipped capital femoral epiphysis (SCFE) is the most common pediatric hip disorder and occurs when mechanical stress or trauma induces slip of the epiphysis, resulting in lower extremity pain and abnormal gait. Standard management is immediate in situ screw fixation (ISF) upon radiographic diagnosis. Delays in the timing of operative fixation inevitably occur due to the inaccessibility of pediatric orthopaedic surgeons, patient demographics, and large referral regions. Delayed operative
more » ... is theorized to increase risk of slip propagation, potentially worsening the injury and leading to adverse outcomes. Recently, some institutions have challenged this dogma and transitioned to performing operative fixation within one week compared to the traditional emergent timeline of definitive fixation occurring between 24-48 hours post-diagnosis. The clinical question of whether delays in operative fixation adversely affect outcomes warrants further literature review.
doi:10.17615/16fp-tj27 fatcat:gwsjsbsh5zfkrb3dkugbdtit4m