Slipped Capital Femoral Epiphysis

November 12, 2012

Slipped Capital Femoral Epiphysis

Children who are obese tend to suffer from a condition which affects the hip bone and thigh bone called SCFE (slipped capital femoral epiphysis).

This results in the hip joint being weakened as a result of the upper part of the thigh bone shifting.

If diagnosis of SCFE is carried out early most of the cases can be successfully treated.

The classification of SCFE is as follows:

  • Stable SCFE where the child experiences some pain or stiffness in the groin or knee area and a limp may occur. The limp and pain can be intermittent symptoms and become worse with physical activity and after rest become better. A person who has stable SCFE can still walk although they may require crutches.

  • Unstable SCFE is more severe. It may be the child cannot put weight on the side that is affected. Moving the foot and leg can become limited and they may start to turn outwards. An SCFE which is unstable is serious as it can result in restricted blood flow to the hip joint which can lead to the tissue dying in that area.

There are nerves which run down the leg that can become irritated which is known as referred pain. This means the pain starts in the abnormal hip joint but the pain is experienced in the knee joint.

The cause of slipped capital femoral epiphysis is not known. But it appears more common in children and teenagers between the age of 11 and 16 who are growing. It tends to be more common in young males although females can be affected.

Children who may have the following disorders or features could be at increased risk as they can affect the health of bones:

  • endocrine disorders, e.g. thyroid disease, growth hormone problems, obesity

  • Radiation and chemotherapy to treat cancer

  • Family history

  • Kidney disease

  • Steroid medication

To diagnose children or teenagers with slipped capital femoral epiphysis they will need to visit an orthopedic doctor. A physical examination is carried out and the range of the motion of the legs and hips is carried out to check for pain. X-rays may also be taken of the hip to check for any displacement at the head of the thigh bone.

Surgery is used to treat SCFE in order to stabilize the bone that has slipped. To avoid any more slippage the doctor will recommend rest and using crutches to avoid any weight being put on the leg which is affected.

Children who have experienced a milder slip may have the surgery carried out as an outpatient. If no complications are experienced the child can leave hospital on the same day.

Extensive surgery may be required for severe slips and this will involve admittance to hospital and a general anesthetic is carried out. The surgeon may perform a procedure to make the other side stable as there is a higher risk of this occurring.

If slipped capital femoral epiphysis is treated and detected early most children respond well to physical therapy which strengthens the leg and hip muscles. The condition will continue to be monitored and x-rays will be carried out.

Children who suffer from unstable SCFE have a greater risk of the development of other problems, e.g. early arthritis, stiff hips, differences in leg length. As they become older they may require surgery to realign the hips as they continue to grow.

To reduce the risk of children suffering from a slipped capital femoral epiphysis parents should encourage healthy eating and an exercise plan. This will help to reduce wear and tear on bones and joints of the children. Speak with the doctor about a healthy and safe diet and also an exercise program.

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