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Physeal Growth Following In Situ Pinning for Slipped Capital Femoral Epiphysis and Hypothyroid Treatment: A Case
Jesse M Galina1, Sawyer D Miller2, Kevin T Schauer3
1Orthopaedic Surgery, Maimonides Medical Center, Brooklyn, USA.
Abstract:
Slipped capital femoral epiphysis (SCFE) is a common adolescent hip condition, most often seen during periods of rapid bone growth. Deficiency in thyroid hormone levels can lead to reduced bone turnover and altered epiphyseal plate activity, which may influence the outcome of SCFE pinning and other orthopedic interventions crossing the epiphysis of the femur. Our patient was a 12-year-old female child with a two-month history of atraumatic right hip pain who presented with bilateral slipped capital femoral epiphysis (SCFE) and underwent successful bilateral in situ pinning. An endocrinology workup revealed untreated hypothyroidism and the patient was started on thyroid replacement. Ten months later, X-rays revealed migration of the screws and the patient required bilateral screw removal and replacement. Patients with previously untreated hypothyroidism at the time of SCFE pinning should be monitored closely with routine X-rays until adequate stabilization of thyroid hormone levels.
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