Is the level of vitamin D deficiency correlated with the severity and bilaterality in slipped capital femoral epiphysis? A case series study

Published online: Aug 23 2022

Shady Elbeshry, Tarek Hassan Abdelaziz, Ahmad Saeed Aly, Shady Mahmoud

From Ain Shams University Hospitals, Cairo, Egypt


The aim of the study is to find the correlation between vitamin D level and the severity of slippage and bilateral development in slipped capital femoral epiphysis (SCFE) cases if any. Thirty-nine patients with moderate-severe stable SCFE were evaluated regarding their vitamin D level and to which extent the severity of vitamin D deficiency, if present, can be correlated with the severity and bilaterality of the slip. Vitamin D serum level was assessed pre- operatively for all patients. In case of deficiency, the patient underwent in situ pinning unless performed before his/her presentation. Alongside, he/she received a vitamin D course until correction prior to the definitive surgery (Imhäuser osteotomy with osteochondroplasty) 6-12 weeks after. Thereafter, osteotomy healing and physis closure were monitored radiologically. Results show that all patients but one had vitamin D deficiency, with an average of 14.39 ng/mL, necessitating vitamin D therapy before proceeding to the definitive surgery. No correlation existed between vitamin D level and Southwick angle severity with a p-value of 0.85. A negative correlation existed between vitamin D level and bilaterality, but not statistically significant (p-value 0.192). Patients’ osteotomy healing was uneventful, and physeal closure was achieved in all the cases that had in situ pinning. We conclude that the severity of Vitamin D deficiency could be linked to the bilateral development of SCFE but not the severity of slippage. Treatment of Vitamin D deficiency facilitates physeal closure.