Slipped capital femoral epiphysis (SCFE) is a hip condition that occurs in adolescents. It is when the ball at the top of the thighbone (femur) slips backward through the growth plate in the hip. Think of the ball as being like a scoop of ice cream that falls off its “cone,” the thigh bone.
Children usually between the ages of 10 and 14 typically have groin pain or a limp, or pain in the thigh or knee. It may occur on both sides. Signs may include waddling gait, decreased range of motion and a painful limp. The range of motion is also restricted.
Several factors play a role in the development of a SCFE. Obesity is the most significant risk factor. SCFE is common in adolescent males, especially black males, but it also affects females. Endocrine diseases such as hypothyroidism, hypopituitarism and renal osteodystrophy can have an impact. Other risk factors include family history, radiation/chemotherapy and mild trauma.
Orthopaedic surgeons have extensive experience in identifying, treating, and managing SCFE. SCFE is diagnosed through physical exams and medical imaging.
Almost all children with the condition require surgery. The procedure involves the placement of one or two pins into the femoral (thigh bone) head to prevent further slippage. The unaffected side may also be pinning if a second SCFE is likely. If SCFE is suspected the patient should be non-weight bearing and placed on bed rest.
Failure to treat a SCFE may result in complete separation of the femoral head from the ball. This may result in avascular necrosis (AVN), hip osteoarthritis, gait abnormalities and chronic pain. SCFE is also associated with a greater risk of arthritis of the hip joint later in life.