Hip Disorders

What Is SCFE?

Slipped capital femoral epiphysis (SCFE) usually occurs during the teenage years when the thighbone is growing at a fast rate. The condition causes the ball part of the of the child's thighbone (capital epiphysis) to slip from the growth plate, causing the child to limp or feel pain in the thigh or knee.

The child's doctor can confirm SCFE by taking an X-ray of the hip. The pain from this condition can be in the hip, thigh or knee area. There are two types of SCFE: a slow slipping of the epiphysis (stable SCFE) and a sudden slipping of the ball part of the hip resulting in severe pain and inability to walk (unstable SCFE).

What Causes SCFE?

The cause is unknown, but the condition may be linked to several factors.

  • Weakness in the bone due to hormone abnormalities (i.e. low thyroid hormone)
  • Excessive weight
  • Family history of hip conditions

How Is SCFE Treated?

If your doctor suspects SCFE, the child should stop walking and be placed into a wheelchair (not crutches) to help prevent further slipping or a sudden slip of the bone, which can cut off the blood supply to the bone. This can cause the ball part of the hip to die (avascular necrosis), resulting in long-term pain, limping or a hip replacement surgery in early adulthood.

When SCFE is confirmed, the child will be admitted to the hospital and put on bed rest. Pain management begins, and skin traction may be used. One of two types of surgery is performed.

  • In Situ Pinning Surgery This less invasive surgery keeps the ball of the thighbone (capital epiphysis) from slipping further and secures it in the current position (in situ). One or two screws are placed through the skin into the thighbone to hold the epiphysis to the top of the thighbone and prevent further slipping.
  • Open Reduction Surgery: This surgical procedure is used for patients with unstable SCFE to align the bone within the hip socket and prevent loss of blood flow to the ball of the thighbone.

After Surgery

After In Situ Pinning, the child may put limited weight on the leg for six to 12 weeks using crutches or as instructed by the physical therapist.

After open reduction surgery, the child is kept on crutches for 12 weeks and not allowed to bear any weight. Children can usually resume athletic activities three months after surgery.