Frozen Shoulder Explained — Why It Hurts, and Why It Takes So Long
27 Jul 2026
Slipped capital femoral epiphysis (SCFE) is the most common hip disorder of adolescenceand understanding the critical distinction between stable and unstable slips is essential for orthopaedic practice. In this OrthoVellum masterclass, we explore the Loder classification, in situ fixation principlesand the management of paediatric hip displacement. ⏱ Chapters 0:00 Intro 0:23 Essentials 1:08 Classification 1:49 Severity 2:26 Algorithm 3:19 Numbers 4:10 Clinical reasoning — Stable 4:36 Clinical reasoning — Unstable This comprehensive video covers the pathology, epidemiologyand clinical presentation of slipped capital femoral epiphysis. We dive deep into the Loder stability classification as the primary prognostic indicator for avascular necrosis (AVN), the Southwick angle for measuring slip severityand the surgical rationale for in situ single screw fixation without reduction. 🦴 IN THIS VIDEO YOU'LL LEARN • How to differentiate stable SCFE from unstable SCFE using the Loder classification • Why avascular necrosis risk dramatically increases from less than one percent to forty-seven percent in unstable slips • How to accurately measure slip severity using the Southwick angle on a frog lateral radiograph • The pathognomonic clinical sign of obligate external rotation during hip flexion • Why in situ single screw fixation is the gold standard and why active reduction must never be attempted • How to apply Klein's line on an AP pelvis radiograph to diagnose subtle slips • The surgical technique for placing a central, perpendicular screw across the physis • When to consider prophylactic pinning of the contralateral hip in high-risk paediatric patients • The anatomical basis of the retinacular vessels and how they influence AVN risk ⏱️ CHAPTERS 📌 KEY TAKEAWAYS ✔️ Stability is everything: a stable slip has under 1% AVN risk, while an unstable slip carries a 47% AVN risk. ✔️ Never attempt an active reduction; fix the slip in situ to protect the retinacular vessels. ✔️ An unstable SCFE is a surgical emergency requiring operative intervention within 24 hours. ✔️ Always assess the contralateral hip, as bilateral involvement occurs in 20-40% of patients. ✔️ Any adolescent presenting with knee or thigh pain must receive a hip radiograph to rule out SCFE. 👩⚕️ WHO THIS IS FOR This masterclass is designed for orthopaedic trainees, medical studentsand junior doctors seeking a comprehensive understanding of paediatric hip disorders. Curious patients and caregivers looking to understand the surgical rationale and prognosis for SCFE will also find this breakdown highly valuable. 📚 RELATED TOPICS: Developmental Dysplasia of the Hip (DDH) · Perthes Disease (Legg-Calvé-Perthes) · Femoroacetabular Impingement (FAI) Secondary to Paediatric Hip Disease · Paediatric Proximal Femur Fractures and AVN · Avascular Necrosis of the Femoral Head · Valgus Intertrochanteric Osteotomy for SCFE Remodelling 🔗 More free orthopaedic teaching at Orthovellum.com — subscribe for weekly videos. 🎨 CREDITS • Original Orthovellum production. ⚠️ DISCLAIMER: Educational only — not individual medical advice. Always consult a qualified clinician for diagnosis and treatment. #orthopaedics #orthovellum #SCFE #slippedcapitalfemoralepiphysis #pediatrichip #paediatrichip #trauma #orthopedicsurgery #avascularnecrosis #hipsurgery #orthopedics #loderclassification #medicalstudent #orthopaedicteaching
27 Jul 2026
