SLIPPED CAPITAL FEMORAL EPIPHYSIS

Slipped capital femoral epiphysis occurs during the adolescent growth spurt and is most frequent in obese children. Up to 40 percent of case s are bilateral. Recent classification methods emphasize epiphyseal st ability rather than symptom duration. Most cases of slipped capital fe moral epiphyses are stable and have a good prognosis if diagnosed earl y. Unstable slipped capital femoral epiphysis has a much poorer progno sis because of the high risk of a vascular necrosis. Early radiographi c clues are the metaphyseal blanch sign and Klein's line. Once diagnos ed, treatment should begin immediately. The most widely accepted treat ment for a stable slipped capital femoral epiphysis is in situ fixatio n with a single central screw. The treatment for an unstable slipped c apital femoral epiphysis is much more controversial. Corrective osteot omy is usually reserved for treatment of revere deformities after the patient has stopped growing.