What is slipped capital femoral epiphysis?

Slipped capital femoral epiphysis is a hip condition that can occur anytime during your preteen or teenage years. SCFE is caused by the head ("ball" part) of the upper end of the thigh bone (femur) slipping backward and downward at the point of the growth plate.

The growth plate is where new bone formation occurs. The growth plate is also referred to as the epiphyseal plate. It can be found in the 'neck' area of the femur, placed between the "ball" section of the femur and its long shaft section. A growth plate consists of cartilage with a soft, flexible layer. It is a weaker section than the rest of the body of the bone during adolescence, in which rapid bone growth occurs. As soon as the head of the femur slips, it changes the anatomical alignment between these parts of the bone,

SCFE can involve one or both of your child's hips and often develops gradually. However, it can also occur suddenly from a fall or other injury.

Is there more than one type of slipped capital femoral epiphysis?

There are two: stable and unstable SCFEs.

• Stable SCFE: Your child will probably be able to walk here. It usually does come with a limb that varies from being on to being off. This will worsen with activity and improve with rest. Pain or stiffness in the hip, groin, or knee occurs from stable SCFE.
• Unstable SCFE: This is a more serious form of the condition. Your child will not be able to bear weight on the affected leg. This type tends to manifest more promptly and is indeed more painful; it can also create additional issues.

Who is at risk for slipped capital femoral epiphysis?

Usually, SCFE occurs in overweight children at the age of 11 to 16 years and is much more common among boys than girls. SCFE occurs much more frequently among African American and Hispanic children in comparison to Caucasians. It also appears to happen much more regularly in children destined to have rapid growth spurts.

How joint is slipped capital femoral epiphysis?

SCFE is the most common hip condition affecting adolescents. It occurs in 11 per 100,000 preteens/teens.

What is the cause of slipped capital femoral epiphysis?

The cause of slipping capital femoral epiphysis (SCFE) is not known. However, specific associations or risk factors have been determined by studies to increase the risk of SCFE. Some of them are:

• Being fat
• Injuring the hip-thigh area by falling or any other accident
• Endocrine disorders: Growth hormone deficiency, hypothyroidism, hyperthyroidism, hypopituitarism, and osteodystrophy, which is literally a condition involving defective bone growth.
• Disease conditions related to kidneys (because they affect calcium, a bone-building block).
• She slipped capital femoral epiphysis family history.

How do people know that they have slipped capital femoral epiphysis?

The symptoms of the slipped capital femoral epiphysis are:

• Groin, knee, or hip pain in your teenager.
• Stiffness in the hip of your teen.
• Foot/leg turned outwards.
• Walks with a limp.
• Can't put any weight on the leg (usually in more severe cases and with extreme pain).
• One leg looks shorter than the other.
• Symptoms may take weeks to several months, or even five months before such a diagnosis is issued.

How is slipped capital femoral epiphysis diagnosed?

SCFE can be diagnosed by performing a physical examination that may involve rotating the affected leg, evaluating while walking, and taking X-rays. Even if SCFE cannot be confirmed with X-rays, if your pediatrician suspects that your child suffers from SCFE, your doctor may recommend ordering an MRI. Your provider may even order blood work to rule out other conditions.

How is slipped capital femoral epiphysis treated?

It needs surgery. Surgery is done to prevent continued slipping and potential complications. The most common surgical procedure is known as 'screw fixation.' In said surgical procedure, the surgeon will pass a screw from the side of the top of the femur through the neck of the femur and through the growth plate into the 'ball' section of the femur. The screw stops the 'ball' section of the femur from slippage.

How soon will you have surgery for slipped capital femoral epiphysis?

This condition may worsen. Surgery should be scheduled as soon as possible. If your teen will have to wait to be seen by the provider, they should stay off their affected leg as much as possible using crutches, a walker, or a wheelchair and get plenty of rest. Your provider will give instructions about appropriate pain relief medicine.

What are some complications of slipped capital femoral epiphysis for my teen?

Serious complications include avascular necrosis and chondrolysis. Avascular necrosis is one of the severe complications that arise when your teen's femoral head has slipped seriously. When this happens, the blood supply to the head of the femur gets cut off, and the hip collapses. This causes osteoarthritis that develops quite rapidly and severely. Reconstructive hip surgery is often needed. It is characterized by sudden and severe destruction of the cartilage in the hip joint.

Other complications include:

• Femur growth stops well before it should.
• SCFE of the opposite hip.
• Premature development of osteoarthritis of the hip.

How soon does one recover after undergoing slipped capital femoral epiphysis surgery?

Your healthcare provider will determine your child's expected time to full recovery. Each child is different, and several factors, such as the severity of SCFE and the type of surgical procedure, play a role in your child's individualization. Generally, you can expect your child to be on crutches or a walker for about four weeks following stable SCFE or at least six to eight weeks following unstable SCFE.

Treatment is geared toward relieving pain and preventing complications. The first course of action might be to limit your teen's activities, particularly those related to sports. Pain and inflammation can be managed through medication. Your teen will see a physical therapist to build strength in their leg and hip muscles and to enhance their range of motion. Talk to your provider about when you re teen can return to normal and resume athletic activities, including sports.

What is my teen's prognosis for slipped capital femoral epiphysis?

The source and degree of the slide will determine your teen's prognosis if they have slipped capital femoral epiphysis. Generally speaking, all teens are at higher risk for developing osteoarthritis, independent of the degree of slip. Eventually, reconstructive hip surgery may be necessary if the symptoms pain, reduction in range of motion, and stiffness in the hip worsen over time.

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