Page 47 - Slipped Capital Femoral Epiphysis Pathogenetic and Clinical aspects

Introduction
Slipped capital femoral epiphysis (SCFE) is a disorder of the proximal femur that
occurs mainly in peripubertal children. It is defined as the displacement of the
femoral neck and shaft relative to the femoral head in the growth plate in which
the proximal femoral neck and shaft move anteriorly and rotate externally relative
to the femoral head, while the femoral head remains in the acetabulum. SCFE has
been described as the most common hip dis-order of adolescent children in the 3 USA [1]. Boys are more susceptible than girls in developing this disorder (Table 1).
It is most often diagnosed in obese children around puberty and in children with endocrinopathies or chronic systemic diseases. In the Netherlands, the incidence of SCFE has never been published. To gain an understanding of SCFE and to compare its incidence in other countries we performed a literature search aimed at determining its incidence in different countries among children of different ages. We then performed a Dutch population-based search to determine the incidence of SCFE in the Netherlands and whether there was a difference between boys and girls. National data on body length and body weight of the children were used to interpret the findings. We compared our results with those of other studies that provide a local incidence of SCFE (Table 1).
Materials and methods
Patients
We performed a search of the national hospital registration system of the Netherlands, i.e. the ‘‘Landelijke Medische Registratie (LMR), PRISMANT kubus Ziekenhuis statistiek’’, which registers all patients admitted to Dutch hospitals. Only age groups and sex are listed in this registration system. Our study period covered the period 1998–2010, and the search items were the diagnosis of non-traumatic SCFE [NT SCFE; International Classification of Diseases, 9th Revision (ICD 9) code 732.2] and traumatic SCFE (T SCFE; ICD 9 code 820.01) as well as a combination of these two groups. The ICD codes only contain figures for the age categories 1–4 years, 5–9 years, 10–14 years and 15–19 years. We restricted ourselves to the age group 5–19 years. NT SCFE can be confused with T SCFE; therefore we counted the entities separately and as a combined group to these different codes. For the population figures we used Statline (Centraal Bureau voor Statistiek, the Netherlands).
Slipped Capital Femoral Epiphysis
45