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L i and colleagues bring to our attention a rarely-reported occurrence following femoral neck fractures in the pediatric population. In the past 40 years, only five instances of slipped capital femoral epiphysis (SCFE) following treatment of Delbert II (trancervical) and III (base of the femoral neck) hip fractures in children have been reported. Li and colleagues present two additional patients and review the sparse literature. The ages of all reported patients range from 3.6 to 12 years. Prior to the present paper, all cases occurred in males. The two patients in the current study, a 12-year-old female and a 6-year-old female, both developed SCFE at 5 months and 9 months, respectively. During the past four decades, treatment for femoral neck fracture has ranged from closed reduction with casting to surgical fixation. Fixation has varied from multiple screws to side plate and screws. Neither BMI nor health status information are included in the current paper. The authors assert that none of the patients had either body habitus or endocrine disease, which are commonly associated with SCFE. Five of the seven patients developed either coxa vara or avascular necrosis prior to the slip, with one exception occurring 5 months to 15 months after the original injury. Only one patient had concomitant pubic rami fractures, suggesting significantly more initial force at time of injury. The authors concluded that SCFE can occur after femoral neck fracture in children, but the causes of this probably are multifactorial and are not well understood.

CORR Insights®: Delayed Slipped Capital Femoral Epiphysis After Treatment of Femoral Neck Fracture in Children