Incidence of Slipped Capital Femoral Epiphysis in Crete (2021–2024): A Prospective Population-Based Study with a Focused Review of the Recent Literature

TL;DR

This study reports the incidence of a hip disorder in children in Crete and compares it to global data, finding it to be relatively low.

Contribution

The study provides the first population-based incidence estimates of SCFE in Crete and Southern Europe.

Findings

The incidence of SCFE in Crete was 4.6 per 100,000 children aged 6–16 years.

Most SCFE cases in Crete involved obese children, with a higher prevalence in females.

The Cretan SCFE incidence aligns with other Mediterranean regions but is much lower than in Sweden.

Abstract

Background: Slipped capital femoral epiphysis (SCFE) is an adolescent hip disorder of high clinical importance in which diagnostic delay may lead to irreversible complications and long-term morbidity, and its incidence varies considerably across populations. Objective: The primary aim of this study was to provide contemporary, population-based incidence estimates of SCFE among children aged 6–16 years in Crete (2021–2024), addressing the lack of data from Greece and Southern Europe. A secondary aim was to contextualize these findings through a focused synthesis of international incidence reports published since 2015. Methods: All pediatric orthopedic specialists in Crete reported incident SCFE cases, all of which were radiographically confirmed. All confirmed cases of SCFE were documented. Annual population data for children aged 6–16 years were obtained from the Hellenic Statistical Authority. Incidence rates were expressed per 100,000 children aged 6–16 (95% CI, exact Poisson). A structured literature search (2015–May 2025) identified recent studies reporting SCFE incidence. Results: Eleven children with SCFE were identified (14 affected hips; three bilateral cases), corresponding to an incidence of 4.6 per 100,000 person-years (95% CI 2.5–7.8) among children aged 6–16 years. Mean age at presentation was 10.72 years, 64% were female, and 82% were obese, with comorbidity findings recorded. The literature review (2015–May 2025; 14 studies) demonstrated substantial geographic variation in SCFE incidence, ranging from ~5 per 100,000 in Mediterranean settings to 57 per 100,000 boys aged 9–15 years in Sweden. The Cretan incidence rate was broadly consistent with other Mediterranean reports. Conclusions: SCFE is an uncommon condition in Crete, with incidence rates comparable to those of other Mediterranean populations. The geographically defined setting and relatively stable demographics support case ascertainment and the interpretability of the incidence estimates. Larger nationwide studies are warranted to better characterize SCFE epidemiology in Greece.