SCFE in Southern Europe. A preliminary epidemiological study

Abstract

[eng] Level-2. Hip/DDH/Legg-Calve´-Perthes/SCFE Introduction Slipped capital femoral epiphysis (SCFE), has showed a large variation between geographical areas: no study has been done in Southern Europe looking at disease characteristics. Materials and methods The data of 130 SCFE, from 5 different teaching hospitals in Spain were reviewed. The demographic data included were age, weight, height, ethnicity and season of the year when diagnosed. Data related to stability, onset of symptoms and amount of displacement were also recorded. Finally, data were collected in relation to the applied treatment and the presence of avascular necrosis (AVN). Results The incidence in boys was twice that of girls. The age of presentation was 12.8 years in boys (median 13) and 11.6 in girls (median 11) (p = 0.005). When we looked at the body parameters of the patients, both boys and girls were heavier than their age group but they were also taller. Therefore, the BMI for boys was on average 23.9 (median 23.5) and 24.05 for girls (median 23.2), ruling out obesity in this group of children. When looking at ethnic origin, 80 % were Caucasian, and a surprising 16.5 % were gypsies (Spanish gypsy population 1.6 %). The time of diagnosis was distributed evenly throughout the year 78 % (102) were stable and 22 % unstable (28), with the same sex distribution and age of presentation. However, when we looked at the relationship between weight and stability, at least in boys, the children with unstable SCFE were 10 kg lighter on average than the whole group (p = 0.027). Displacement was measured using the Wilson and the Southwick methods; both methods show a high concordance (kappa 0.78). Around 60 % were minimally displaced. The ages for the different degrees of displacement were similar. Unstable SCFE were always more displaced than the stable, this relationship was significant for both boys (p\0.001) and girls (p = 0.005). Only 8 patients presented AVN; 5 were stable and 3 unstable. By sex 6 were females (4 stable/2 unstable) and 2 male (1/1). AVN occurred in a 4.2 % of unreduced SCFE and in a 8.6 % of reduced cases, so chances of AVN after reduction doubled (p = 0.5). Conclusion Patients with SCFE, at least in our background, are not overweight but rather are bigger than their peers. Gypsy population may have a bigger susceptibility to SCFE. Significance First epidemiological SCFE study performed in the Southern of Europe that may add some more information in the understanding of this condition.