It is a fracture of the growth plate at the top of the femur. In this condition, the problem occurs in the upper area while the bone is still growing. It is separated from the main part of the bone by the growth plate. Hefny division of paediatric orthopaedics and limb reconstruction surgery, department of orthopaedic surgery, faculty of medicine. Epidemiology and demographics of slipped capital femoral. Capital femoral epiphysis definition of capital femoral. Slipped capital femoral epiphysis scfe remember this song from when you were little. The full text of this article is available in pdf format. Current concepts in management of slipped capital femoral epiphysis 2 march 2018 hip international, vol. Slipped capital femoral epiphysis uf health, university. Slipped capital femoral epiphysis genetic and rare. Scfe is a condition that affects the top of the femur thighbone of older children and teenagers. Slipped capital femoral epiphysis, in situ screw fixation, femoroacetabular impingement.
Slipped capital femoral epiphysis is a common paediatric hip disease and the incidence is on rise over the years. Slipped capital femoral epiphysis scfe is a hip disorder that occurs in school children during the period of active growth between the ages of 10 and years. A slipped capital femoral epiphysis may affect both hips. Childrens orthopaedics the treatment of an unstable. Slipped capital femoral epiphysis scfe is a disorder of the.
Slipped capital femoral epiphysis scfe is the most common hip pathology in adolescents, it involves displacement at the epiphyseal plate growth plate involving the epiphysis and metaphysis. Some of the commonly encountered problems are depression, gall stones, sleep apnea, orthopedic problems such as slipped capital femoral epiphysis in teenagers the hip end of upper leg bone and increased fractures, spine and feet problems, hypertension, and earlier onset of puberty in females and delayed genital maturation in males. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is a disorder in which the femoral head ball of the thigh bone slips off the neck of the femur thigh bone though the growth plate. Southwick osteotomy in stable slipped capital femoral epiphysis. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is an unusual but not rare disorder of the adolescent hip. High survivorship and little osteoarthritis at 10year followup in. It involves weakness of the growth plate epiphyseal plate located at the top of the. Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10.
Scfe is often described as being like a scoop of ice cream slipping off the top of a cone. Please use one of the following formats to cite this article in your essay, paper or report. Slipped capital femoral epiphysis scfe is a hip condition that affects older children and teenagers. Slipped capital femoral epiphysis scfe is a hip disorder that occurs in adolescence. Slipped capital femoral epiphysis is known to produce characteristic deformities in the proximal femur, which affect hip motion and may cause a limp. Jun 01, 2018 slipped capital femoral epiphysis slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. But how attuned are we to this diagnosis, how common is scfe and what are the risk factors for it. But in some teens particularly those who are obese the hip joint is weakened by slipped capital femoral epiphysis scfe. Slipped capital femoral epiphysis scfe is the most common hip disorder in children 915 years old.
Often atraumatic or associated with a minor injury, slipped capital femoral epiphysis scfe is one of the most common adolescent hip disorders and represents a unique type of instability of the proximal femoral growth plate. The capital femoral epiphysis is the head of the femur. Slipped capital femoral epiphysis in children health. Jun 15, 2017 slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, occurring in 10. Online mendelian inheritance in man omim is a catalog of human genes and genetic disorders. B, with displacement of the capital epiphysis, this dense triangle is lost because this portion of the femoral neck is located lateral to the acetabulum. Scfe is associated with a highly variable degree of posterior translation of the epiphysis and simultaneous anterior displacement of the metaphysis. In scfe, the ball of the thighbone femoral head slips off the neck of the thighbone. Slipped capital femoral epiphysis definition femoral epiphysis is a secondary boneforming center of the femur, separated from the main part of the bone by cartilage during the period of bone. For reasons that are not well understood, the ball at the head of the femur thighbone slips off the neck of the bone in a backwards direction. A good, stable connection at your hip joint is what lets you walk, run, make that jump shot, and shake it on the dance floor. This paper assessed the 3d gait kinematics in adolescents after single screw fixation of moderate to severe. A slipped capital femoral epiphysis occurs when the upper end of the thigh bone femur slips at the area where the bone is growing growth plate or physis and does not fit in the hip socket correctly. Scfe results in posterior displacement of the proximal femoral epiphysis in relation to the metaphysis.
Radiographic appearance of slipped capital femoral epiphysis scfe on presentation. The modified dunn procedure for slipped capital femoral epiphysis. Once discovered, emergent surgery is necessary to prevent complications. Factors influencing the development of osteonecrosis in patients treated for slipped capital femoral epiphysis. Oct 09, 2012 slipped capital femoral epiphysis scfe is a disorder of the immature hip in which anatomic disruption occurs through the proximal femoral physis. Scfe is associated with a highly variable degree of posterior translation of the epiphysis and. The appropriate treatment in mild slipped capital femoral epiphysis scfe should not only prevent further slipping of the epiphysis but also address potential femoroacetabular impingement by restoring the anatomy of the proximal femur. More common in pacific islander and maori population.
Diagnosis can be made on ap and frog leg lateral radiographs. Slipped capital femoral epiphysis scfe, also known as slipped upper femoral epiphysis sufe, is the result of a salterharris type i physeal fracture. Slipped capital femoral epiphysis scfe is an adolescent hip disorder that is characterized by slippage of the femoral epiphysis through the epiphyseal plate. Slipped capital femoral epiphysis scfe is a hip condition that occurs in teens and preteens who are still growing. Slipped capital femoral epiphysis what you need to know. Sometimes it can be misdiagnosed as a traumatic femoral head fracture. A multicenter study by the korean pediatric orthopedic society kwangsoon song, md, changwug oh, md,w hyunjoo lee, md,w and sedong kim, mdz. Slipped capital femoral epiphysis uf health, university of.
Slipped capital femoral epiphysis current concepts in treatment eduardo novais, md assistant professor of orthopedic surgery development anterior axial mild 60o severity southwick 1969 stability loder criteria loder 1993 unstable osteonecrosis 550%. Open reduction of slipped capital femoral epiphysis. For reasons that are not well understood, the ball at the upper end of the femur thigh. Purpose slipped capital femoral epiphysis scfe is the commonest hip. First, your child will have xrays to see how severe the scfe is. This is a pdf file of an unedited manuscript that has been. Slipped capital femoral epiphysis stanford health care. Open reduction of slipped capital femoral epiphysis information for the public published. The ball at the top of the femur the femoral head sits on a growth plate, which is made of cartilage that is weaker than bone. It usually occurs in children eight to 15 years of. Diagnosis and treatment of slipped capital femoral. Diagnosis and management david peck, md, providence athletic medicine, novi, michigan s lipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, usually 9occurring between eight and 15 years of age. Most cases are idiopathic but there are associated risk factors.
Research article open access slipped capital femoral epiphysis. This paper assessed the 3d gait kinematics in adolescents after single screw fixation of moderate to severe, stable, unilateral slipped capital femoral epiphysis. Slipped capital femoral epiphysis scfe texas childrens hospital. Pdf slipped capital femoral epiphysis researchgate.
In situ pinning is commonly performed, yet lately there has been an increase in procedures with open reduction and internal fixation. Scfe usually occurs in those eight to 15 years of age and is one of. Sometimes it turns out to be a slipped capital or upper femoral epiphysis. Open reductionof aslipped capital femoral epiphysiscarries a high risk of avascular necrosis, a. Nice interventional procedure guidance, january 2015. Scfe is extremely rare in adults, and nearly all previous reported cases have been. Slipped capital femoral epiphysis genetic and rare diseases. Each entry has a summary of related medical articles. Slipped capital femoral epiphysis scfe is the most common nontraumatic hip disorder in adolescents, although its occurrence is rare. Perry et al looked at these questions using a cohort study over 23 years. Diagnosis and treatment of slipped capital femoral epiphysis.
Slipped capital femoral epiphysis scfe is a disorder in which the femoral head ball of the thigh bone slips off the neck of the femur thigh bone though the. This is a populationbased study in sweden presenting the epidemiology for scfe. Slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, is a relatively common condition affecting the physis of the. Dec 03, 2018 slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice. Slipped capital femoral epiphysis scfe is a salterharris type i fracture through the physeal plate of the proximal femur resulting in displacement. The etiology of scfe includes biomechanical and biochemical factors. Scfe may develop in one leg or it may occur in both legs. A good, stable connection at your hip joint is what lets you walk, run, make that jump shot, and shake it.
After surgery, your child may stay overnight for one night. The aim of this study was to quantify length of the remodeling phase mediated by growth of the femoral neck, after treatment of scfe with a screw. Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. Slipped capital femoral epiphysis scfe is a condition which predominantly occurs in adolescents. The growth plate is a soft area of the bone that makes bones grow into their adult length and shape. It occurs when the epiphysis head of the femur thighbone slips off the neck of the bone. Patients typically present between 12 and 14 years of age. Slipped capital femoral epiphysis femur epiphysis slipping.
Slipped capital femoral epiphysis, fixation by single. Moderate to severe chronic stable slipped capital femoral epiphysis scfe produce permanent ir regularities in the femoral head and acetabulum. Coronal images show widening of the right femoral physis and a. The ball at the upper end of the femur thigh bone slips off in a backward direction. Evolution of slipped capital femoral epiphysis after in situ screw. A 9 yearold girl presents with a limp and pain in the right hip after a fall, few weeks ago. Slipped capital femoral epiphysis scfe is a common adolescent hip disorder. Jul 20, 2016 slipped capital femoral epiphysis scfe is the commonest hip disorder in adolescents. Feb 27, 2019 please use one of the following formats to cite this article in your essay, paper or report. It involves weakness of the growth plate epiphyseal plate located at the top of the femur thigh bone causing the head of the femur to slip backwards and downwards. In scfe, the physis is not strong enough to withstand the shear forces acting on. It is meant for health care professionals and researchers. Slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, occurring in 10. Although scfe is a rare condition, an accurate diagnosis combined with immediate treatment is critical.
Surgery may be needed to keep the epiphysis from slipping any further. Slipped capital femoral epiphysis slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. Slipped capital femoral epiphysis adolescent hip pain. Surgery may be scheduled for the same day your child has the xrays or, your child may need to be admitted to the hospital until the surgery can be done. The treatment of slipped capital femoral epiphysis scfe has been. Longterm outcomes of slipped capital femoral epiphysis.
Fixation in slipped capital femoral epiphysis avoiding. It develops during periods of accelerated growth, shortly after the onset of puberty. Slipped capital femoral epiphysis treatment and surgery. The term slipped capital femoral epiphysis is actually a misnomer, because the epiphysis is held in the acetabulum by the ligamentum teres.
Slipped capital femoral epiphysis scfe is a condition of the hip joint that affects children. 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. A, appearance of acute scfe on a frogleg lateral view. Slipped capital femoral epiphysis sydney childrens hospitals. Scfe occurs more common in obese males and occurs in early adolescence. Slipped capital femoral epiphysis scfe epidemiology. In japan, as the number of obese patients increases, obesity seems to be involved in the onset of slip both biomechanically and. Slipped capital femoral epiphysis scfe is a disorder of the immature hip in which anatomic disruption occurs through the proximal femoral physis. Feb 27, 2019 a slipped capital femoral epiphysis scfe is a condition in which the head of the femur separates from the adjacent growth plate or epiphysis at the upper end of the femur.
Slipped capital femoral epiphysis scfe is a common hip disorder in children and adolescents, and it consists in posteroinferior migration of the epiphysis in metaphysis through the physis in proximal femur. Scfe occurs when the ball at the upper end of the femur femoral head. It should be suspected in any adolescent who complains of hip or knee pain. Slipped capital femoral epiphysis scfe is the commonest hip disorder in adolescents. Slipped capital femoral epiphysis sydney childrens hospital. Epiphysiolysis femoris slipped capital femoral epiphysis, scfe. Slipped capital femoral epiphysis scfe, causing posterior and inferior. Since 2000, four series have reported rates of avn between 0% and %, 811 although only the work of parsch 11 involved 30 patients. Slipped capital femoral epiphysis scfe also known as slipped upper femoral epiphysis sufe is a disorder involving the hip joint. In orthopedic literature, there is little consensus regarding the best management of slipped capital femoral epiphysis scfe. Scfe is a condition that affects the top of the femur. Slipped capital femoral epiphysis, fixation by single screw. Slipped capital femoral epiphysis scfe or skiffy, slipped upper femoral epiphysis, sufe or souffy, coxa vara adolescentium is a medical term referring to a fracture through the growth plate physis, which results in slippage of the overlying end of the femur.
Epidemiology and demographics of slipped capital femoral epiphysis in korea. Slipped capital femoral epiphysis scfe occurs following failure of the proximal femoral physis, resulting in displacement of the proximal femoral epiphysis relative to the femoral neck and shaft. Well, the song may be silly, but one thing is true. These procedures, however, are technically demanding with relatively high complication rates and unknown longterm outcomes. This can be found here and is summarised in the following infographic. Childrens orthopaedics the treatment of an unstable slipped. Various epidemiological factors have been associated with it and there is also a trend of changing patterns with respect age of presentation and pathomechanics. Results of a survey of the membership of the bscos and the wko.
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