SUFE (slipped upper femoral epiphysis) pinning is an urgent operation to stabilise the growth plate at the top of the thighbone in a child or adolescent when it has slipped out of position. A single screw is placed across the growth plate to prevent further slippage.
Under X-ray guidance, a single cannulated screw is inserted through the outer thigh, across the femoral neck, and into the femoral head epiphysis, crossing the growth plate to prevent further slip. The screw is left permanently. The operation takes 30–60 minutes. For unstable slips, urgent surgery within hours is critical.
SUFE is an emergency — the growth plate is slipping and further displacement worsens outcomes. Pinning in situ (in its current position) prevents further slip and allows the growth plate to fuse.
There are no effective non-operative alternatives for SUFE. Without fixation, the slip progresses.
This is an urgent/emergency procedure. X-rays confirm the diagnosis. The child is kept non-weight-bearing and prepared for theatre.
Prevention of further slippage. The growth plate fuses over the following months. Most patients with mild to moderate stable slips have good long-term outcomes.
The affected leg may be slightly shorter as growth plate closure is accelerated.
Internal rotation is typically limited.
Loss of blood supply to the femoral head. Risk is highest in unstable (acute) slips — approximately 20-50% for unstable slips vs less than 5% for stable slips.
Cartilage destruction causing stiffness and pain. Risk approximately 5%.
The other hip may slip (approximately 20-40% risk). Prophylactic pinning may be discussed.
The screw may inadvertently enter the joint, damaging cartilage.
Rarely, the slip may progress despite fixation.
General anaesthesia. Positioned supine on a fracture table with X-ray guidance.
Non-weight-bearing or partial weight-bearing for four to six weeks. Crutches. Gradual return to full activity. The other hip is monitored closely.
Regular follow-up with X-rays every three to six months until growth plate closure. The other hip is monitored.
SUFE commonly presents with knee pain because the hip and knee share nerve pathways. Any child with unexplained knee or thigh pain should have their hip examined.
There is a 20-40% risk of the other hip slipping. Your surgeon will discuss whether preventive (prophylactic) pinning of the other hip is advisable.