Slipped capital femoral epiphysis (SCFE) is a disorder of the hip that occurs in adolescents, especially due to obesity or injury, as the teenage years are a time of rapid bone growth. Also Read: 5 Effective Ways To Build Your Child’s Bone Health
New bone is formed at a specific area of the bone called the growth plate. In thigh (femur) bones, the growth plate is in the ‘neck’ area of the bone between the ‘ball’ section and the long shaft section of the femur. The growth plate is made up of cartilage, which is a soft, flexible layer. Because it is the area where new bone is forming, it is weaker than the rest of the bone. In SCFE, the ‘ball’ section of the femur slips backward at the growth plate. This slip causes a shift in the normal alignment of the ‘ball’ section of the femur and the neck section of the femur. Also Read: Hip Dysplasia: Causes, Symptoms And Treatment
The disorder can occur in one or both hips and develops gradually. It can also occur suddenly due to a fall or other injury.
Typically, SCFE occurs in overweight children between 11 and 16 years old and is more common in boys than girls.
Slipped capital femoral epiphysis occurs when the head of the thighbone (femur) slips off the neck of the bone at the growth plate. The growth plate is where new bone forms. It is the weaker area of the bone during the adolescent years when children are still growing.
Extra body weight on the bones from being overweight or obese, rapid growth, a fall or other injury to the hip-thigh area can put an adolescent at risk for developing slipped capital femoral epiphysis.
If left untreated, SCFE can lead to grave consequences when teens enter adulthood. Major complications are avascular necrosis and chondrolysis. Avascular necrosis is a serious complication that occurs in patients with severe slippage. When this happens, the blood supply to the head of the femur can be cut off and the hip begins to collapse. This results in rapid and severe arthritis. Chondrolysis is a condition that occurs when there is a sudden and severe destruction of cartilage in the hip joint.
Hence, it is recommended to seek immediate medical care once characteristic signs of slipped capital femoral epiphysis are recognized in a teenager.
The typical indications of slipped capital femoral epiphysis in teenagers are:
Stiffness and soreness in the hip
Foot/leg that is turned outward
Walking with a limp
One leg appears shorter than the other
Diagnosis And Treatment:
SCFE can be diagnosed through physical exam, observation while walking, and X-rays. These tests help the doctor determine the extent of damage to the ball and socket joint in the hips of teenagers, how debilitating the symptoms are and decide upon the right course of treatment.
Treatment comprises surgery, by a procedure known as screw fixation. The goal of surgery is to prevent further slippage and avoid complications. In this process, the surgeon passes a screw from the side of the top of the femur, through the neck of the femur, through the growth plate and into the ‘ball’ section of the femur. The screw keeps the ‘ball’ section of the femur from slipping out of place.