Slipped Capital Femoral Epiphysis (SCFE)
What is slipped capital femoral epiphysis?
What's the difference between stable and unstable SCFE?
What are the symptoms of stable SCFE?
What are the symptoms of unstable SCFE?
What are the complications of SCFE?
When can my child get back to normal activities?
Will my child recover completely?
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Slipped Capital Femoral Epiphysis (SCFE)
What is slipped capital femoral epiphysis?
Slipped capital femoral epiphysis (SCFE) is a hip problem that starts if the epiphysis (growing end) of the femur (thigh bone) slips from the ball of the hip joint. SCFE may develop in one leg or it may occur in both legs.
Who can get SCFE?
SCFE usually occurs in children between 11 and 16 years old. SCFE often occurs in children who are overweight. More boys than girls get SCFE, and it's more common in blacks than in whites. The cause of SCFE usually isn't known. SCFE is typically divided into 2 types: stable and unstable.
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.
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.
What are the symptoms of stable SCFE?
A child with stable SCFE may first have stiffness in the hip, which may get better after rest. After a while, the stiffness may turn into a limp, and the child may have pain that comes and goes. The pain is often felt in the groin, the thigh or the knee and not necessarily in the hip itself.
In the later stages, the child may lose some ability to move the involved hip. This leg will usually twist out. It may look shorter than the other leg. He or she may not be able to play sports or do simple tasks such as bending over to tie his or her shoes. The symptoms may change gradually or rapidly.
In the later stages, the child may lose some ability to move the involved hip. This leg will usually twist out. It may look shorter than the other leg. He or she may not be able to play sports or do simple tasks such as bending over to tie his or her shoes. The symptoms may change gradually or rapidly.
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. If you think your child has unstable SCFE, don't force the leg to move. That could make the thigh bone slip even more.
How is SCFE diagnosed?
To check for stable or unstable SCFE, your doctor will take x-rays that show the pelvis and thigh area from several angles. Your doctor will then decide which tests are needed and explain each test to you.
How is SCFE treated?
Once SCFE is diagnosed, your doctor will probably refer your child to an orthopedic surgeon (a doctor who fixes bone problems). 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. The results of this treatment are good. It has few complications.
Other surgical treatments (including in-situ fixation with more than one screw) are used less often. Ask your doctor to explain the potential benefits and risks of the treatment options.
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. The results of this treatment are good. It has few complications.
Other surgical treatments (including in-situ fixation with more than one screw) are used less often. Ask your doctor to explain the potential benefits and risks of the treatment options.
What are the complications of SCFE?
The most serious complications of SCFE are avascular necrosis (a lack of blood flow to the bone) and chondrolysis (decay of cartilage). Avascular necrosis is more common in patients with an unstable SCFE.
The risk of these complications increases as the severity of SCFE increases. This is why it is important to get treatment right away.
The risk of these complications increases as the severity of SCFE increases. This is why it is important to get treatment right away.
When can my child get back to normal activities?
Getting better takes time. For 4 to 6 weeks after surgery, your child will need to use crutches to walk. Then your child can slowly get back into normal activities, including running and contact sports.
Will my child recover completely?
If SCFE is caught early, there is a good chance for full recovery, especially if SCFE is stable. Some children who have had SCFE may get arthritis in the hip later in life.
More Information
Source
Written by familydoctor.org editorial staff.
Slipped Capital Femoral Epiphysis by RT Loder (American Family Physician May 1, 1998, http://www.aafp.org/afp/980501ap/loder.html)
Reviewed/Updated: 11/06
Created: 05/98
Copyright © 1998-2008 American Academy of Family Physicians
|This article provides a general overview on this topic and may not apply to everyone. To find out if this article applies to you and to get more information on this subject, talk to your family doctor.
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|This article provides a general overview on this topic and may not apply to everyone. To find out if this article applies to you and to get more information on this subject, talk to your family doctor.
For private, noncommercial use only.
Home | Privacy Policy | Contact Us | About This Site | What's New |