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What is Slipped Capital Femoral Epiphysis, and Could My Child Be at Risk?

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It is a long phrase for an unusual disorder: Slipped capital femoral epiphysis (SCFE). This refers to a disorder, while not usual, is not rare, either.

For reasons the medical community does not fully understand, this occurs when the ball at the upper end of the thigh bone slips off into a backward direction. A weakness in the growth plate can be attributed to this condition. In many cases, it presents during the beginning of puberty when accelerated periods of growth occur.

SCFE is more common in males than in females, occurring two to three times more frequently. A large percentage of the patients have excess weight in comparison to their height. The slipping of the epiphysis is a gradual process in most cases. Nonetheless, it can come on suddenly as a result of some sort of trauma or a fall. When treated well in the early stages, SCFE that is symptomatic in nature can see positive long-term functioning of the hip.

The symptoms most associated with SCFE include weeks or months of hip or knee pain, perhaps accompanied by an occasional limp. The adolescent may even be unable to bear any weight on the leg that is affected. This leg may be turned outward as compared to the other leg. Further, this leg may look somewhat shorter than the other one.

To provide for a complete and accurate diagnosis, a physical examination is necessary. A thorough history of the patient is obtained and his/her walking pattern will be observed. Further, x-rays of the hip will be performed, and the results of these x-rays should detail that “the upper end of the thigh bone does not line up with the portion called the femoral neck,” as noted in the web site “Your Orthopaedic Connection.”

Many times, complete hip movement is lost and it is difficult for the patient to rotate his/her hip forward. The increased inflammation in that area may also cause pain with extreme movement and perhaps even contribute to muscle spasms.

The treatment of SCFE does require surgical intervention. This is done to prevent any further slipping of the femoral head until the growth plate closes. Any additional slippage of the head could further reduce the patient’s ability to move his/her hip. Osteoarthritis could also begin to present at this time.

Once SFCE is diagnosed, it is imperative to begin treatment within a couple of days. The goal of treatment is to stabilize the hip. The surgical implementation of pins and screws has been the favored option to treat this condition, with a screw into the thighbone and into the femoral epiphysis and possibly a couple of screws into the femoral head. The abnormal growth plate is removed and screws are then inserted to help prevent further displacement.

Post-surgical care involves instructing the patient as to the use of crutches. The patient will most likely have to rely upon these for weeks, if not months, until a full recovery is made. The patient should receive close medical supervision for up to two years after the surgery. After such a time, it is necessary to perform x-rays to the site every three months or so to make sure the abnormal growth plate properly fused.

Again, slipped capital femoral epiphysis is a long term for a condition that requires a great deal of time to correct, but the end results should prove to be satisfying and truly in the best interest of the patient.

Information for this article was obtained at http://orhtoinfo.aaos.org/topic.cfm?topic+A00052.

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Expert HERWriter Guide Blogger

Hi Ann - Thanks for making us aware of this unusual disorder. Could you please give us an idea of how frequently slipped capital femoral epiphysis (SCFE) occurs?
Many thanks,

November 5, 2009 - 5:41pm
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.

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