Abstract

Slipped capital femoral epiphysis (SCFE) is considered one of the common hip disorders in children and adolescents that is commonly complicated by bilateral involvement. Prophylactic fixation and observation are two main management strategies. The current review and meta-analysis aimed to determine whether prophy lactic fixation of the contralateral hip in pediatric patients with unilateral SCFE is associated with reduced incidence of subsequent contralateral slip in comparison with observation. This was a systematic review and meta-analysis that was conducted in accordance with PRISMA guidelines. A search of the literature was conducted across different databases in order to include comparative studies between prophylactic fixation and observation of the contralateral hip. Data extracted included study design, sample size, patient demographics, intervention details, and contralateral slip rates. The review included five comparative studies, showing a significantly reduced incidence of contralateral slip among patients on prophylactic fixation in comparison with the observation group, with a risk ratio of 0.05 (95% CI: 0.01-0.19, p < 0.0001). Younger age was identified as a strong predictor of contralateral slip in observed patients. Both groups showed a rare incidence of serious complications, while growth-related issues and reoperation were more common in the observation group. Prophylactic fixation of the contralateral hip in the pediatric population with unilateral SCFE is considered a safe option that is associated with reduced risk of subsequent contralateral slip. The benefits appear greatest in younger patients at higher risk for bilateral disease.

Key words: Prophylactic fixation, contralateral hip, unilateral, slipped capital femoral epiphysis, pediatric populations, systematic review