Definition

Slipped capital femoral epiphysis (SCFE) happens when the ball in the hip joint at the end of the thigh bone slips backwards and partly off the bone. It happens in the pre-teen or teen years. Stable SCFE starts slowly and gets worse over time. Unstable SCFE is severe and can be sudden.

The Hip Joint

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Causes

SCFE is caused by pressure on an area of cartilage that allows the bone to grow, known as the growth plate.

Risk Factors

SCFE is more common in boys and children who are aged 8 to 16 years. Other things that raise the risk are:

• Obesity
• Rapid growth
• Hormone disorders, such as hypothyroidism or growth hormone deficiency

Symptoms

Symptoms of stable SCFE may be:

• A limp with or without pain
• Pain in the groin, hip, thigh, or knee that comes and goes for weeks or months
• Pain that is worse with activity

Symptoms of unstable SCFE may be:

• Sudden pain, often after an injury
• Problems bearing weight on the leg
• A severe outward turning of the leg
• The leg looks shorter than the healthy leg

Diagnosis

You will be asked about your child's symptoms and health history. An exam will be done that focuses on the hip joint and how it moves. This can be enough to make the diagnosis.

Images of the hip joint will be taken to confirm the diagnosis. This can be done with x-rays.

A wheelchair or crutches will be used to keep weight off of the hip joint. More treatment will be given by a doctor who treats bones.

Treatment

The goal of treatment is to stabilize the joint and prevent any further slipping. This is always done with surgery. The surgery that is done depends on whether the SCFE is stable or unstable:

• Stable SCFE: A metal screw will be put through the bone and across the growth plate to hold it in place until the growth plate closes.
• Unstable SCFE: The doctor will move the head of the femur back into place. One or two metal screws will be used to hold the bone in place until the growth plate closes.

Prevention

There are no methods to prevent SCFE.