[Complications of slipped capital femoral epiphysis]

Slipped capital femoral epiphysis is well known disorder of the hip in adolescents, which is characterized by displacement of the capital femoral epiphysis from the metaphysis through the physeal plate. The incidence of slipped capital femoral epiphysis is about 5-8 cases per 100,000 adolescents. Etiology of slipped capital femoral epiphysis is still unknown, but this disorder is probably combination of genetic, hormonal and mechanical factors. On the basis of patient's history, physical examination, and radiographs, slipped capital femoral epiphysis can be classified as acute or chronic. Two most severe complications of slipped capital femoral epiphysis are avascular necrosis and chondrolysis. Avascular necrosis is more commonly associated with the acute slips when the lateral epiphyseal vessels are disrupted. In chronic slips, avascular necrosis can occur as a result of treatment. Chondrolysis or cartilage necrosis can occur in untreated slips, but is often associated with spica cast imobilization or penetratation of the internal fixation screws into the joint space. The final outcome of avascular necrosis and chondrolysis is extremly poor for a patient. Therefore, the baseline of management of slipped capital femoral epiphysis is treatment by adequate techniques that have high rate of success with minimal risk of complications.