What complications can occur in patients with slipped capital femoral epiphysis. Slipped capital femoral epiphysis scfe is a hip condition that occurs in teens and preteens who are still growing. It is when the ball at the top of the thighbone femur slips backward through the growth plate in the hip. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Slipped capital femoral epiphysis scfe is an adolescent hip disorder that is characterized by slippage of the femoral epiphysis through the epiphyseal plate. 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. This most commonly occurs during puberty and affects children aged 1115. When a slipped capital femoral epiphysis occurs, the bone separates at the growth plate and becomes displaced.
In slipped capital femoral epiphysis scfe, severity of slippage correlates with poor longterm clinical outcome 18. Slipped capital femoral epiphysis the upperend of the thigh bone femur is a round ball shape that joins the socket of the pelvis to form the hip joint. Slipped capital femoral epiphysis scfe, as the name suggests, involves the posterior slippage of the proximal femoral epiphysis due to mechanical shearing forces, with concomitant extension and external rotation of the femoral neck and shaft fig. The hip is a ballandsocket joint, which means that the rounded end of one bone in this case, the ball of the thighbone fits into the hollow of another bone the acetabulum, or cupshaped socket of the pelvis. Slipped capital femoral epiphysis scfe or slipped upper femoral epiphysis. Any child between the ages of 10 and 15 years presenting with thigh, knee, andor hip pain and no special history of trauma should have a good hip examination to rule out slipped capital femoral epiphysis. The epiphyseal slip can occur acutely with a sudden traumatic episode. Cases have been reported as early as age nine years old. Slipped capital femoral epiphysis is a condition in which the epiphysis on the femoral head is displaced posteriorly with respect to.
In this condition, the problem occurs in the upper area while the bone is still growing. Several factors can contribute to a slipped capital femoral epiphysis, though the main cause is rapid growth in the bones of the leg due to spurts and. Slipped capital femoral epiphysis femur epiphysis slipping. Impingement in scfe has been associated with damage of the acetabular cartilage, which may explain early onset of osteoarthritis after scfe. Skeletal immaturity is evident in radiographic imaging by the presence of a growth plate, or physis. From may 2009 to january 2015, 208 maine coon cats presented to the tierklinik hollabrunn a small animal referral and firstopinion centre. Slipped capital femoral epiphysis symptoms, causes. Slipped capital femoral epiphysis leads to early osteoarthritis resulting from fai. 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. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, plural. He was running down the field when he heard and felt a crack in his right hip. Age of onset 815 years old peak age of onset occurs during maximal pubertal growth spurt. This condition often develops during the rapid growth period after the onset of puberty.
Remove a cylindrical core consisting of metaphyseal bone physis and a portion of the epiphyseal bone there by. When this happens, the blood supply to the head of the femur can be cut off and the hip begins to collapse. Apr 21, 2015 severity of scfe frogleg lateral pelvis radiograph of a patient with a 44 slipped capital femoral epiphysis moderate, with an epiphysealshaft angle of 56 on the right and of 12 on the left 56 12 44. Progressive slippage after pinning for slipped capital femoral epiphysis article in journal of pediatric orthopaedics 222. Slipped upper femoral epiphysis radiology reference article. In short, scfesufe is where the very top of the balljoint cracks leaving the rest of the thigh bone to slip out of place.
Awareness of this diagnostic possibility in the population at greatest risk and knowledge of subtle and early radiographic findings will allow prompt diagnosis and treatment of scfe. This often involves surgery to secure the growth plate physis with a single screw or with pins. While the head of the bone is still connected to the joint, the rest of the femur is forced outward. Slipped capital femoral epiphysis scfe for parents. Slipped capital femoral epiphysis treatment houston tx. Proximal prolongation of the superior neck line transects the epiphysis in the normal hip right but either lies flush with or does not. Feb 06, 20 slipped capital femoral epiphysis vamshi kiran feb 620 1. Slipped capital femoral epiphysis physical therapy in. This pattern is likely due to closure of growth plates occurring between 7 to 10 mo of age and that under 6 mo of age the bone of the femoral neck is weaker than the cartilage of the growth plate 3. Hefny division of paediatric orthopaedics and limb reconstruction surgery, department of orthopaedic surgery, faculty of medicine, ainshams university, 38 abbasia, cairo 11566, egypt. It develops between 1216 years in boys and 1014 years in girls.
The term slipped capital femoral epiphysis is actually a misnomer, because the epiphysis remains in its normal anatomical position in the acetabulum due to the ligamentum teres femo. The condition is defined as the posterior and inferior slippage of the proximal femoral epiphysis on the metaphysis femoral neck, which occurs through the epiphyseal. Slipped capital femoral epiphysis scfe is defined as a posterior and inferior slippage of the proximal femoral epiphysis femoral head on the metaphysis femoral neck, occurring through the epiphyseal growth plate during the early adolescent growth spurt. 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 joe dimaggio. This condition is commonly caused during accelerated growth periods such as the onset of puberty. Spontaneous femoral capital physeal fractures in adult cats. Normally, the head of the femur, called the capital, should sit squarely on the femoral neck. Slipped capital femoral epiphysis vamshi kiran feb 620.
Management of severe slippage of the capital femoral. Slipped capital femoral epiphysis demands surgical management except in rare instances, as stabilization of the epiphysis and early fusion of the proximal femoral physis prevents further displacement and is a common goal of all treatment modalities. 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 detected in a. Macindoe introduction the aims of treatment of slipped capital femoral epiphysis scfe are. Orthoseek orthopedic topics slipped capital femoral epiphysis. A slipped upper femoral epiphysis sufe is a condition involving the hip joint.
Slipped capital femoral epiphysis is a slippage of the epiphyseal growth plate of the head of the femur during a growth spurt. The dynamed team systematically monitors clinical evidence to continuously provide a synthesis of the most valid relevant evidence to support clinical decisionmaking see 7step evidencebased methodology guideline recommendations summarized in the body of a dynamed topic are provided with the recommendation grading system used in the original guidelines, and. 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. Scfe is the most common hip disorder in adolescents, usually occurring between 10 and 17 years of age. In this condition, the growth center of the hip the capital femoral epiphysis actually slips backwards on the top of the femur the thighbone. Slipped capital femoral epiphysis scfe is a salterharris type1 fracture through the proximal femoral physis and is the most common adolescent hip disorder. Jun 05, 2018 slipped capital femoral epiphysis or scfe is a type of progressive disorder of the hip joint, which is more common among preteens and teens. Slipped capital femoral epiphysis scfe is the most common hip disorder affecting adolescents. Spontaneous capital femoral physeal fracture in a cat. Kids scfe slipped capital femoral epiphysis bone talks. Avascular necrosis is a serious complication that occurs in patients with severe slippage.
A slipped capital femoral epiphysis may affect both hips. Oct 09, 2012 slipped capital femoral epiphysis is the most common hip disorder affecting adolescents. Slipped capital femoral epiphysis in 17 maine coon cats. A slipped capital femoral epiphysis occurs when the upper, or capital, epiphysis of the thigh bone femur slips sideways off the end of the femur. Slipped capital femoral epiphysis, is a common hip disorder in adolescence, in which the growth plate fractures. Slipped capital femoral epiphysisscfecausessymptoms.
The physis is the active area of skeletally immature bones which allows length to be added to that bone. The very top of the femur thigh bone forms the ball also called femoral head, and beneath this ball lies a growth plate an area of growing tissue that allows the bones to lengthen, also called the epiphyseal plate. No cats older than 12 mo had traumatic capital epiphyseal separation. Slipped capital femoral epiphysis american family physician. Slipped capital femoral epiphysis davis and derosa. This is caused due to weakness of the growth plate. Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10. Slipped capital femoral epiphysis scfe is a failure process in which slippage of the two parts of the femur is produced at its growth plate in the hip joint.
Slipped capital femoral epiphysis is defined as a posterior and inferior slippage of the proximal femoral epiphysis on the metaphysis femoral neck, occurring through the physeal plate during the. Slipped capital femoral epiphysis everything you need to know dr. Slipped capital femoral epiphysis scfe hip joint, posterior and inferior slippage of proximal femoral epiphysis on the femoral neck metaphysis. It is separated from the main part of the bone by the growth plate. A slipped capital femoral epiphysis scfe is a posteroinferior slippage of the proximal. Abnormal movement along the growth plate results in the slip. Proximal prolongation of the superior neck line transects the epiphysis in the normal hip right but either lies flush with or does not transect the epiphysis in scfe left hip. Failure to recognise this injury may cause long term damage and surgery may be required. Because treatment of advanced slippage is difficult, early diagnosis of slipped capital femoral epiphysis is vital. However, there are few case reports of older patients in the literature to date. The subsequent development and severity of degenerative changes is related to the degree of slippage and to delay in diagnosis. Slipped capital femoral epiphysis scfe is a common hip disorder in adolescents causing slippage or separation of the femoral head ball at the upper end of the femur bone from the weakened epiphyseal growth plate growing end of the bone. Scfe, also pronounced as skiffy, is known as atraumatic fracture of the hypertrophic zone of the physeal plate of the femoral capital epiphysis.
The radiographic characteristics of slipped capital femoral epiphysis are. Early diagnosis of slipped capital femoral epiphysis on. This answer provided for nata by the university of tampa athletic training education program. Slipped capital femoral epiphysis and hypothyroidism in a. Slipped capital femoral epiphysis scfe is an unusual disorder of the hip where the ball at the upper end of the thigh bone femur slips in a backward direction. It is more common in boys aged 11 to 16 years old and usually develops gradually but can occur suddenly.
Surgical hip dislocation in treatment of slipped capital. Slipped capital femoral epiphysis scfe is the most common hip disorder. Outcomes of total hip replacement in patients with slipped capital. Slipped capital femoral epiphysis is a medical term referring to a fracture through the growth plate, which results in slippage of the overlying end of the femur. Thus, we considered that the epiphyseal separation at the vertebral body was the basic. It if more than twice as common in males than females at a ratio of 2. Slipped capital femoral epiphysis scfe is considered the most common adolescent hip disorder. The goal of treatment for a slipped capital femoral epiphysis is to prevent further slippage, restore the normal position of the bones, and reduce complications of the condition. Epidemiology and demographics of slipped capital femoral. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is a common hip disorder in adolescents causing slippage or separation of the femoral head ball at the upper end of the femur bone from the weakened epiphyseal growth plate growing end of the bone.
Slipped capital femoral epiphysis long term effects. Xrays show widening of the epiphyseal line or apparent posterior and inferior displacement of. 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. Many children are quite active during an active slip. A slipped capital femoral epiphysis occurs when there is a fracture at the neck or top of the thigh bone causing hip pain. Chronic severe slipped capital femoral epiphysis considerably alters hip joint architecture, inexorably leading to arthritis. Slipped capital femoral epiphysis kaiser permanente. It is associated with obesity and has a higher incidence among black, hispanic and polynesian racial groups. It usually occurs in children eight to 15 years of. Crackcast show notes musculoskeletal disorders may 2017. Think of the ball as being like a scoop of ice cream that falls off its cone, the thigh bone.
It is known to affect boys more often that girls with a maletofemale ratio of approximately 1. Slipped capital femoral epiphysis is when the top part of the thighbone, shaped like a ball, slips off the straight part of the thighbone. Such a patient will present after a fall or injury during. The result is a slippage between the neck of the femur and the overlying head of femur also called the capital or epiphysis. Histologically, growth plate injury such as epiphyseal separation was observed. Most cases are idiopathic but there are associated risk factors. Mar 16, 2017 slipped capital femoral epiphysis scfe is the most common hip abnormality presenting in adolescence and is a primary cause of early osteoarthritis.
Slipped capital femoral epiphysis fort lauderdale hip. This causes pain, stiffness, and instability in the affected hip. If untreated, this can lead to serious problems in the hip. The percentages for laterality of involvement were similar in boys and girls. It most commonly affects older and teenage boys adolescents who are overweight.
Start studying slipped capital femoral epiphysis scfe. Slipped capital femoral epiphysis scfe seattle childrens. This condition often develops during the rapid growth period after the onset of puberty, and may affect one or both legs at a time. Slipped capital femoral epiphysis scfe is a condition that happens in adolescents where the epiphysis the growth center of the femoral head displaces or slips out of alignment from the rest of the femur. Slipped capital femoral epiphysis is the most common hip disorder affecting the adolescent population, usually individuals between 8 and 15 years old. Slipped capital femoral epiphysis management and treatment. It is a disorder of the immature hip in which anatomic disruption occurs through the proximal femoral physis. Feb 27, 2019 slipped capital femoral epiphysis is a condition in which the epiphysis on the femoral head is displaced posteriorly with respect to the femoral neck, altering the mechanics and articular. Slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice.
A scfe is not a crack in the bone, but more like a crack in the growth plate. Slipped capital femoral epiphysis treatment and surgery. The presentation is that of a fracture of the hip, and xrays will confirm the diagnosis. Typically, scfe displays itself in only one hip while the other is normal. Restoring normal anatomy is an attractive prospect, made difficult, however, by the risk of an iatrogenic damage to epiphyseal vascularization. Anteroposterior and frogleg lateral xrays of both hips are taken. Xray showing a slipped capital femoral epiphysis, before and after surgical fixation. Slipped capital femoral epiphysis flashcards quizlet.
About slipped capital femoral epiphysis to understand scfe, it helps to know a little about the hip joint. Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. Slipped capital femoral epiphysis scfe also known as slipped upper femoral epiphysis sufe is a disorder involving the hip joint. Slipped capital femoral epiphysis scfe is a hip condition that occurs in adolescents. Pinning in situ without reduction with a single cannulated screw is the method of choice for the treatment of a slipped capital. The head of the femur slips or fractures at the base of the hip joint, causing it to move out of place. A normal and abnormal epiphyseal line as described by klein et al. Such a patient will present after a fall or injury during sports, complaining of severe pain in the hip. A slipped capital femoral epiphysis is a hip injury that typically occurs in adolescents shortly after puberty. Major complications are avascular necrosis and chondrolysis. Oct 10, 2014 slipped capital femoral epiphysis is the most common hip disorder affecting the adolescent population, usually individuals between 8 and 15 years old.
A growth spurt can put excess pressure on the area, leading to a slippage. Progressive slippage after pinning for slipped capital. Slipped capital femoral epiphysisscfe is a condition in which femoral head epiphysis or the head of the thigh bone slips off the neck of the thigh bone due to weak epiphysis present in the upper edge of the thigh bone. Displacement of the femoral head over the corresponding metaphysis at the level of the physeal plate separation and subsequent slippage of the femoral head resulting from an acute shearing or avulsion trauma to the physeal plate is relatively frequent in neonates and children under 5 years of age haliburton et al. Oct 27, 2017 ankle growth plate fracture symptoms, what happens if you break your growth plate, growth plate fracture, ankle growth plate pain, shoulder growth plate fracture, growth plate injury, salter. Slipped capital femoral epiphysis scfe sufe steps charity. Slipped epiphysis birmingham hip joint replacement birmingham.
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. In an incomplete fracture the bone cracks but doesnt break all the way through. Started in 1995, this collection now contains 6767 interlinked topic pages divided into a tree of 31 specialty books and 732 chapters. The growth plate is relatively weak and susceptible to injury.
It is the part of a long bone where new bone growth takes place. It is one of the commonest hip abnormalities in adolescence and is bilateral in 20% of cases. The young rats in the vehicle group showed slippage and wedging deformity radiographically, deformities which were similar to those in pediatric patients with spondylolisthesis. Scfe is a misleading term because it is actually the femoral neck metaphysis that displaces with respect to the capital femoral epiphysis 1. This condition often develops during the rapid growth period after the onset of puberty, and may. Feb 27, 2019 slipped capital femoral epiphysis or scfe is the most common adolescent hip disease. Slipped capital femoral epiphysis occurs during the adolescent growth spurt and is most frequent in obese children. Introduction and definition epidemiology and risk factors classification pathogenesis signs and symptoms diagnosis investigations management modalities complications 3. Slipped capital femoral epiphysis scfe flashcards quizlet.
It is believed that the etiology is multifactorial and may include obesity, trauma and, less frequently, endocrine pathologies comprising hypothyroidism. Slipped capital femoral epiphysis or scfe is the most common adolescent hip disease. Slipped capital femoral epiphysis midwest bone and joint. Slipped capital femoral epiphysis scfe is a condition that affects the hip in teenagers between the ages of 12 and 16 most often. Current orthopaedics 1996 10, 179184 1996 pearson professional ltd children management of severe slippage of the capital femoral epiphysis m.
It is characterized by a posterior displacement of the epiphysis through the hypertrophic zone with the metaphysis taking on an anterior and superior position. Some conditions increase the risk for both hips to slip, such as endocrine disorders like hypothyroidism. Slipped capital femoral epiphysis linkedin slideshare. Slipped capital femoral epiphysis need not be painfully disabling. We discuss a scfe slipped capital femoral epiphysis. A scfe occurs when there is a weakening in the femur growth plate, causing the ball to slip off the neck on the upper thigh bone. The epiphyseal plate or epiphysial plate, physis, or growth plate is a hyaline cartilage plate in the metaphysis at each end of a long bone. Once discovered, emergent surgery is necessary to prevent complications.