The Epidemiology of Slipped Capital Femoral Epiphysis in American Samoa.

The Maori of New Zealand have been identified as a high-risk population for slipped capital femoral epiphysis (SCFE). This study assessed whether the burden of disease from SCFE in the American Territory of American Samoa is similar to that identified in the Maori. This was a retrospective review of children from American Samoa treated for SCFE at a tertiary care pediatric hospital between 2005-2014. Demographic, clinical, and radiographic information was collected. All patients were followed for at least one year after surgery and prophylactically pinned hips were not included. Data for determining incidence was obtained from the United States Census Bureau. Between 2005-2014, 55 American Samoan youth were treated for 73 SCFE. The incidence in the "at-risk" population 5-14 years of age was 53.1 per 100,000. Patients had a mean BMI of 29.5 (19.4-46.4) and mean weight of 76.7 kg (45.9-139 kg). Southwick angle was a mean 40.6°+/- 20.4° (6-83°). Overall, 82.2% of hips were treated with in-situ cannulated screw fixation. At a minimum one-year after initial surgery, 22 hips (30.1%) required major surgery including intertrochanteric osteotomy, osteochondroplasty, or total hip replacement. The incidence of SCFE in American Samoa is extremely high, 53.1 per 100,000 of "at-risk" population 5-14 years old. The mean weight and BMI in SCFE patients from American Samoa is substantially higher than previously published reports. Furthermore, morbidity from SCFE in this population is substantial with 30.1% requiring major surgery either at the time of physeal stabilization or in subsequent years.

The epidemiologic characteristics of slipped capital femoral epiphysis in Maori children.

BACKGROUND: Slipped capital femoral epiphysis (SCFE) has been shown to have considerable racial variation. Children of Polynesian, and especially Maori, ethnicity are thought to have the highest worldwide incidence. Despite this, very little published literature exists to corroborate this. The aim of this study was to describe the characteristics of SCFE in the largest series of Maori children ever published. METHODS: Case notes and radiographs were used to analyze the demographic and slip characteristics of all SCFE admissions over a 10-year period. Comparisons of these characteristics were made between Maori and New Zealand European (NZE) children and census data were used to provide incidences and racial frequencies for the two groups. RESULTS: A total of 130 Maori children and 44 NZE children had a new diagnosis of SCFE during the study period. For the "at-risk" age group (5 to 14 y), incidence in Maori children (81/100,000) was significantly higher than NZEs (11.3/100,000) (P≤0.001). Maori had a more even distribution of SCFE between males and females (P=0.04), with a lower age at presentation (P=0.002) and a higher incidence of bilateral SCFE (P=0.05). Female children also had a younger age at presentation (P=0.001) and higher incidence of future contralateral SCFE (P=0.02). CONCLUSIONS: This is the first published study primarily looking at the epidemiologic characteristics of SCFE in Maori children. It would appear that Maori children have the highest reported worldwide frequency of SCFE and present at a younger age with a greater rate of bilateral SCFE than their counterparts. LEVEL OF EVIDENCE: Prognostic Level III.