Suspected slipped capital femoral epiphysis in an adolescent requires which immediate management?

• A. Urgent percutaneous pinning
• B. Broad-spectrum antibiotics
• C. Observation
• D. External fixation

Answer: (B)

The key idea is that slipped capital femoral epiphysis is a surgical emergency requiring immediate stabilization to prevent progression and preserve the blood supply to the femoral head. The correct approach is urgent in situ percutaneous pinning of the slip, usually with a single screw, to hold the epiphysis in place without forceful reduction. This limits further displacement and reduces the risk of avascular necrosis and deformity.

Antibiotics have no role in the initial management unless there is an infection such as septic arthritis. Observation is inappropriate because delaying fixation allows the slip to worsen. External fixation is not the standard initial treatment for SCFE.