Slipped capital femoral epiphysis in children engaged in sports

BACKGROUND: Epiphysis displacement factors in slipped capital femoral epiphysis are defined as an external mechanical impact on the affected joint of different orientation and intensity, the nature of which may determine the type, direction, and severity of epiphysis displacement. There may be differences in the immediate causes of dislocation and in the nature of the course and timing of detection of the disease in children who were engaged in sports compared to those who were not engaged in sports. Identifying these differences may be beneficial for preventing the occurrence of epiphyseal displacement in slipped capital femoral epiphysis.

AIM: To determine the immediate causes of epiphyseal displacement and the peculiarities of the course of SCFE in children practicing sports.

MATERIALS AND METHODS: The study included 256 patients aged 11–14 years with slipped capital femoral epiphysis who were admitted at our center, from whom 68 patients were subsequently selected. The main group included 34 children who were engaged in sports and whose first symptoms of the disease appeared during training. The control group included 34 children who were not engaged in sports activities and whose first symptoms of the disease appeared for no apparent reason. Clinical, radiologic, and statistical methods of research were used.

RESULTS: In the main group, no severe forms of slipped capital femoral epiphysis such as bilateral displacement, acute displacement with chronic displacement, and early complications of the disease were noted, whereas in the control group, the number of patients with such conditions was 6 (17.6%), 4 (11.8%), and 1 (2.9%), respectively. Additionally, in 2 (5.9%) children of the main group, an extremely rare “valgus” displacement of the epiphysis was detected. Both cases occurred in gymnast girls owing to the use of a special “split” sitting technique.

CONCLUSIONS: Severe forms of slipped capital femoral epiphysis are less frequent in children who practiced sports than in those who were not engaged in sports. This is associated with earlier medical attention. “Valgus” displacement of the epiphysis is more common in children with slipped capital femoral epiphysis who practiced sports than in those who did not do sports. This may be attributed to the use of some of the most traumatic exercises in the training process.