Slipped Capital Femoral Epiphysis (SCFE)

Slipped Capital Femoral Epiphysis (SCFE) is an orthopedic emergency involving a Salter-Harris type I fracture of the proximal femoral physis. It classically affects overweight adolescent males during growth spurts; 25-30% are bilateral.

Klein’s Line (AP view): A line drawn along the lateral femoral neck normally intersects at least 1/6 of the epiphysis. In SCFE, it intersects less or misses entirely.

Frog-leg Lateral: Best demonstrates the posterior-medial slip (the "ice cream slipping off the cone" sign). Caution: Positioning may worsen displacement.

Management: Pinning in situ without physical reduction prevents the major complication: avascular necrosis.