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Definition

What is slipped capital femoral epiphysis?

A slipped capital femoral epiphysis (SCFE) is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone. A slipped capital femoral epiphysis may affect both hips. An epiphysis is an area at the end of a long bone. It is separated from the main part of the bone by the growth plate. In this condition, the problem occurs in the upper area while the bone is still growing.

How common is slipped capital femoral epiphysis?

Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. It is more common in growing children ages 11 to 15, especially boys, obese children, children who are growing rapidly, and children with hormone imbalances caused by other conditions. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of slipped capital femoral epiphysis?

The common symptoms of slipped capital femoral epiphysis are:

  • Difficulty walking, walking with a limp
  • Knee pain
  • Hip pain
  • Hip stiffness
  • Outward-turning leg
  • Restricted hip movements

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.

Causes

What causes slipped capital femoral epiphysis?

The cause of SCFE is unknown.

Risk factors

What increases my risk for slipped capital femoral epiphysis?

There are many risk factors for slipped capital femoral epiphysis, such as:

  • Obesity
  • Medications (such as steroids)
  • Thyroid problems
  • Radiation treatment
  • Bone problems related to kidney disease

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is slipped capital femoral epiphysis diagnosed?

Physical examination

During the examination, your doctor will ask about your child’s general health and medical history. He or she will then talk with you about your child’s symptoms and ask when the symptoms began.

While your child is lying down, the doctor will perform a careful examination of the affected hip and leg, looking for:

  • Pain with extremes of motion
  • Limited range of motion in the hip–especially limited internal rotation
  • Involuntary muscle guarding and muscle spasms

Your doctor will also observe your child’s gait (the way he or she walks). A child with SCFE may limp or have an abnormal gait.

X-rays

This type of study provides images of dense structures, such as bone. Your doctor will order x-rays of the pelvis, hip, and thigh from several different angles to help confirm the diagnosis.

In a patient with SCFE, an x-ray will show that the head of the thighbone appears to be slipping off the neck of the bone.

How is slipped capital femoral epiphysis treated?

The goal of treatment is to prevent the mildly displaced femoral head from slipping any further. This is always accomplished through surgery.

Early diagnosis of SCFE provides the best chance of stabilizing the hip and avoiding complications. When treated early and appropriately, long-term hip function can be expected to be very good.

Once SCFE is confirmed, your child will not be allowed to bear weight on his or her hip and will probably be admitted to the hospital. In most cases, surgery is performed within 24 to 48 hours.

Procedures

The surgical procedure your doctor recommends will depend upon the severity of the slip. Procedures used to treat SCFE include:

  • In situ fixation. This is the procedure used most often for patients with stable or mild SCFE. The doctor makes a small incision near the hip, then inserts a metal screw across the growth plate to maintain the position of the femoral head and prevent any further slippage. Over time, the growth plate will close, or fuse. Once the growth plate is closed, no further slippage can occur.
  • Open reduction. In patients with unstable SCFE, the doctor may first make an open incision in the hip, then gently manipulate (reduce) the head of the femur back into its normal anatomic position. The doctor will then insert one or two metal screws to hold the bone in place until the growth plate closes. This is a more extensive procedure and requires a longer recovery time.
  • In situ fixation in the opposite hip. Some patients are at higher risk for SCFE occurring on the opposite side. If this is the case with your child, your doctor may recommend inserting a screw into his or her unaffected hip at the same time to reduce the risk of SCFE. Your doctor will talk with you about whether this is appropriate for your child.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage slipped capital femoral epiphysis?

Not everyone can prevent SCFE. But reaching and maintaining a healthy weight can spare bones and joints from the excess wear and tear that can weaken and damage them. If your child is overweight and you need help developing a safe diet and exercise plan, talk to your child’s doctor.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Sources

Review Date: November 1, 2017 | Last Modified: November 1, 2017

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