Slipped capital femoral epiphysis (SCFE)

What is SCFE

Slipped capital femoral epiphysis (SCFE) also known as Slipped upper femoral epiphysis (SUFE) is a non common condition of the hip that occurs in growing children and teenagers.

In SCFE the upper part of the femur (thighbone) slips off the neck of the bone.

According to Loder classification, there are two types of SCFE

• Stable SCFE. The patients have pain but can walk
• Unstable SCFE. It is a more severe condition that usually happens suddenly. It is more painful and the child is not able to walk or to weight bear.

Both conditions require urgent treatment

Slipped capital femoral epiphysis symptoms

As described above, symptoms may vary depending on the severity of the condition.

They may include:

• pain in the hip
• pain in the groin, thigh or knee
• limping
• walking with a leg turned outward

Pain is usually aggravated during activity.

In unstable SCFE other symptoms may be:

• inability to walk
• leg length discrepancy
• sudden onset of pain

Slipped capital femoral epiphysis causes

The exact cause of SCFE is still unknown.

Most cases affects child between 12 and 15 years old during a growth spurt.

It is more common in boys that girls. Other risk factors may include:

• obesity or excessive weight
• family history
• endocrine disorders such as diabetes, hyperthyroidism, growth hormone problems
• chemotherapy
• bone problems related to kidney disease (rickets)

SCFE diagnosis

During physical examination the orthopedic surgeon will check the range motion of the hips and ask about symptoms and medical history. Hips are usually hypomobile, externally rotated and short.

He may also order X-rays of the hip or MRI (magnetic resonance imaging) that can allow an early diagnosis.

Slipped capital femoral epiphysis treatment

SCFE it is always treated with surgery.

The goal is to prevent the femoral head from slipping further.

It is recommended to perform surgery as soon as possible.

During surgery the orthopedic surgeon will inserts steel screws and pins across the growth plate to hold the femoral head in the correct position and prevent from any further slippage.

Prof. Portinaro’s experience with SCFE

Prof. Portinaro is one of the most qualified surgeons in the world for hip diseases and treatments.

He performed around 200 surgeries with femoral head reposition in the anatomical place