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Delayed-onset of slipped capital femoral epiphysis

  • Original Article
  • Published:
Journal of Orthopaedic Science

Abstract

Background

Slipped capital femoral epiphysis in adults is uncommon. The purpose of this study was to report our own four cases (six hips) of slipped capital femoral epiphysis (SCFE) in adulthood and to review the cases reported in the literature. The authors attempted to investigate the various causative underlying disorders and clinical characteristics, treatment, outcome, and complications.

Methods

We searched for all 22 reported cases of SCFE in adults age 18 years and older via MEDLINE and Google Scholar from 1963 to 2012 without any exception. In doing so, we documented our own four cases, along with seven additional reports that we found in the literature but were not reported by Hu et al. in 2011.

Results

All of 22 cases involved causative pathology: panhypopituitary disorders in 11, hypothyroidism in five, Kallmann syndrome in three, postradiation hypoestrogenism in one, hypogonadotropic hypogonadism as sequel of meningitis in one, and Klinefelter syndrome in one. Eight cases (36 %) involved both hips. The most common treatment modality was internal fixation combined with hormonal replacement therapy. Nineteen hips (63 %) healed well without any complications after fixation of the slipped epiphysis. Avascular necrosis of the femoral head developed in one hip after in situ pin fixation.

Conclusion

Awareness of the variety of conditions under which SCFE can occur is an important factor in early diagnosis, especially in slippage at atypical ages. In the adults with SCFE, it is very important to look for bilateral involvement as this occurs in 36 % of cases.

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Acknowledgments

Medical editor Katharine O’Moore-Klopf, ELS (East Setauket, NY, USA) provided professional English-language editing of this article.

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Dongsan Medical Center, Keimyung University, 56 Dalsungro, Jung-gu, Daegu, 700-712, Korea

    Kwang Soon Song & Si Wook Lee

  2. Department of Orthopedic Surgery, St Mary’s Hospital, The Catholic University, Seoul, Korea

    Youg Wook Lim & In Young Ok

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  1. Kwang Soon Song
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  2. Youg Wook Lim
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Correspondence to Kwang Soon Song.

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The authors did not receive grants or outside funding in support of their research or preparation of this manuscript.

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Song, K.S., Lim, Y.W., Ok, I.Y. et al. Delayed-onset of slipped capital femoral epiphysis. J Orthop Sci 20, 78–86 (2015). https://doi.org/10.1007/s00776-014-0660-x

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  • DOI: https://doi.org/10.1007/s00776-014-0660-x

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