Slipped Capital Femoral Epiphysis (SCFE)

Slipped Capital Femoral Epiphysis (SCFE) is a hip condition that occurs when the ball at the top of the thigh bone (also known as the femoral head) slips backwards, away from the lower portion of the thigh bone.

SCFE usually occurs in one hip, but both hips can be affected in 20 to 40 percent of people with SCFE. Once SCFE is found in one hip, the greatest risk for developing it in the other hip is within 18 months.

The exact cause of SCFE is unknown. It often develops during rapid growth in adolescence, most likely because of weakness in the growth plate.

SCFE occurs in roughly one to 10 of every 100,000 adolescents. Males are twice as likely as females to develop SCFE. Several factors might increase the risk of developing the condition:

• Being overweight or obese.
• Having a family history of SCFE.
• Having conditions that affect hormones, kidneys, the thyroid or the autoimmune system.
• Taking certain medications or receiving chemotherapy treatments.

The symptoms and effects of SCFE differ from person to person, but some of the most common are:

• Limping.
• Difficulty walking.
• Hip, groin or knee pain.
• Inability to bear weight on the affected leg.
• An affected leg that turns inward, turns outward or appears shorter.
• Decreased range of motion.
• Joint stiffness.

Early diagnosis and treatment of SCFE is important for preventing long-term joint damage. At Gillette Children’s, diagnosis typically includes a review of your child’s medical history, a physical exam and one or a combination of tests to look for SCFE:

• X-ray.

• MRI.

• Bone scan.

Once you find out your child has SCFE, it’s important to prevent the femoral head from slipping farther away from the rest of the thigh bone. Your child needs to remain on bed rest to avoid bearing weight on the affected joint, until surgery can reposition or stabilize the hip joint.

SCFE Surgery

The type of surgery needed to correct SCFE depends on the severity of your child’s condition, symptoms and overall health. Surgery typically involves making an incision near the hip. To prevent additional slipping, Gillette specialists stabilize the femoral head and growth plate with screws and pins. In more severe cases, your child might need additional surgery to reposition the joint or reshape the bone. Sometimes, as a precautionary measure, surgeons stabilize the unaffected hip along with the affected hip.

After surgery, physical therapy typically helps children strengthen the hip and leg muscles and regain mobility. We usually monitor the unaffected hip to ensure that SCFE does not develop.

It’s ideal to identify and treat SCFE as soon as possible. The pediatric orthopedic specialists at Gillette who treat SCFE are nationally and internationally recognized as leaders.

Your family will have access to a variety of specialists that collaborate to determine a comprehensive treatment plan for your child’s condition. We will help you determine which services you need—the services most often involved in the care and treatment of SCFE include:

• Orthopedics.
• Orthotics.
• Rehabilitation therapies.

In addition to treatment for SCFE, Gillette can also offer treatment for related conditions such as early arthritis or hip pain. Our goal is to help your child achieve the highest levels of health, independence and happiness.