Slipped Capital Femoral Epiphysis

The Injury

In SCFE, the head, or "ball," of the thigh bone (referred to as the femoral head) slips off the neck of the thigh bone.

epiphysis [growth plate] of the femur (thighbone) becomes separated from the rest of the bone.

The Tissues

What's the difference between stable and unstable SCFE?

A child is considered to have "stable" SCFE if he or she can walk with or without crutches. More than 90% of cases are stable.

A child who can't walk, even with crutches, has "unstable" SCFE. Unstable SCFE often occurs after a trauma, such as a sports injury or a fall. Falling can also cause a stable SCFE to be unstable.

SPORTS INJURIES

This can occur with a traumatic sports injury like soccer or basketball. Any direct blow to the hip in young children in any sports may cause this injury.

How It Is Caused

caused by many factors, including obesity, physical orientation, abnormalities in physical architecture and hormonal changes during adolescence that affect physical strength.

Age Groups

occurs during the adolescent growth spurt and is most frequent in obese children.

it is more common in black or Polynesian children and occurs slightly more often in boys than in girls (60 percent versus 40 percent).

What are the symptoms of stable SCFE?stiffness in the hip, which may get better

after rest. The stiffness may turn into a limp. The pain is often felt in the groin, the thigh or the knee.

In the later stages, the child may lose some ability to move the hip. This leg will usually twist out. It may look shorter than the other leg. They may not be able to play sports or do simple tasks such as bending over to tie his or her shoes.

What are the symptoms of unstable SCFE?

A child with unstable SCFE has extreme pain. The pain is similar to what might be felt with a broken bone. The child probably won't be able to move the injured leg.

How Long Does It Take to Heal?

Getting better takes time. For 4 to 6 weeks after surgery, the child will need to use crutches to walk. Then the child can slowly get back into normal activities, including running and contact sports.

Course of Treatment

Once SCFE is diagnosed, surgery is usually the treatment of choice. It's important to get treatment right away.

The most common treatment of SCFE is called "in-situ fixation." With this treatment, the bone is held in place with a single central screw. This screw keeps the thigh bone from slipping and will close the growth plate.

Prevention And Precaution

In most cases, slipping of the epiphysis is a slow and gradual process. However, it may occur suddenly and be associated with a minor fall or trauma. If treated early and well, it will allow for good long-term hip function.