A Five-Year-Old Slipped Capital Femoral Epiphysis Treated With Dynamic Single Screw Fixation

Slipped capital femoral epiphysis (SCFE) commonly occurs during puberty. Onset of SCFE at either less than 10 years old or over 16 years is defined as atypical. As in our patient, atypical onset at less than 10 years occurred in 9%, and the age of onset has been decreasing in recent years and that the probability of concomitant obesity is particularly high in young patients without obvious underlying disease or background factors. In the treatment of SCFE, preventing further slipping and permitting femoral bone growth by physeal closure is difficult, especially for young patients. We adopted 'dynamic single screw fixation' using SCFE short thread screw for continuous fixation without disturbing the growth of proximal femur or damaging to growth plate. Refixation was necessary once. The screw worked for 7 years 4 months while physeal closure was avoided. At the 10-year follow-up, her growth had stopped. She had no problem clinically, no increase in the posterior sloping angle (PSA), and no obvious growth disturbance of the femur.