Stasikelis pj1, sullivan cm, phillips wa, polard ja. Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10. The etiology of scfe includes biomechanical and biochemical factors. In this condition, the problem occurs in the upper area while the bone is still growing. The incidence of slipped capital femoral epiphysis scfe remains controversial. Slipped capital femoral epiphysis scfe is a hip disorder that involves the epiphysis eh piff i siss.
Although associated with considerable safety and acceptable prognosis. Slipped capital femoral epiphysis american family physician. The full text of this article is available in pdf format. It is meant for health care professionals and researchers. The most common are avascular necrosis avn of the femoral head and chondrolysis. Slipped capital femoral epiphysis scfe remains the most common adolescent hip disorder 15. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe, a relatively common disorder in childhood, occurs most commonly between age 814 years.
Users must combine epiphyses, slipped and femur head. Subsequently, the femoral head slips relative to the shaft below. Perry et al looked at these questions using a cohort study over 23 years. A slipped capital femoral epiphysis scfe is a shearing phenomenon in which the growth plate at the top of the femur is overwhelmed. Slipped capital femoral epiphysis scfe, also known as slipped upper femoral epiphysis sufe, is characterized by a displacement of the capital femoral epiphysis from the femoral neck through the physeal plate epidemiology. Etiology scfe is a relatively common hip disorder in adolescents, with an incidence of approximately 10 per 100,000 in the united states. 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. Slipped capital femoral epiphysis scfe is a common hip disorder in children and adolescents, and it consists in posteroinferior migration of the. 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. Scfe is a condition that affects the top of the femur thighbone of older children and teenagers. In scfe, the ball of the thighbone femoral head slips off the neck of the thighbone.
Xray showing a slipped capital femoral epiphysis, before and after surgical fixation. Most cases present with stable slips 6, and in situ. Slipped capital femoral epiphysis scfe is the most common nontraumatic hip disorder in adolescents, although its occurrence is rare. Age of onset 815 years old peak age of onset occurs during maximal pubertal growth spurt. Slipped capital femoral epiphysis in atypical patients. But how attuned are we to this diagnosis, how common is scfe and what are the risk factors for it. Slipped capital femoral epiphysis care your child has been treated for a condition of the hips called slipped capital femoral epiphysis ihpifihsis, or scfe skiffee.
Slipped capital femoral epiphysis scfe is a common adolescent hip disorder. Slipped capital femoral epiphysis scfe is a disorder of the. Slipped capital femoral epiphysis genetic and rare. Dysmorphy negative distance gt femoral head center.
Slipped capital femoral epiphysis scfe is a hip condition that occurs in teens and preteens who are still growing. It is separated from the main part of the bone by the growth plate. Surgery was done to help keep the head and neck of the femur bone the long bone in the thigh in place while healing takes place. Slipped capital femoral epiphysis uf health, university. Slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice. Scfe usually presents unilaterally, but can occur bilaterally.
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. Scfe occurs in approximately two of every 100,000 adolescents. If the growth plate breaks, the femoral head will move or slip out of place. The suggestion is made that children who combine overweight with slower than average maturation may be at particularly high risk for slipped epiphysis. Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. Slipped capital femoral epiphysis is the most common hip disorder affecting the adolescent population, usually individuals between 8 and 15 years old. The growing end epiphysis of the thigh bone femur slips off from the top of the femur.
Sometimes it can be misdiagnosed as a traumatic femoral head fracture. A normal and abnormal epiphyseal line as described by klein et al. Slipped capital femoral epiphysis scfe sydney children. About slipped capital femoral epiphysis to understand scfe, you first have to know a little about the hip joint. It develops during periods of accelerated growth, shortly after the onset of puberty. More common in pacific islander and maori population. A slipped capital femoral epiphysis may affect both hips. Slipped capital femoral epiphysis sydney childrens hospital. Slipped capital femoral epiphysis, in situ screw fixation, femoroacetabular impingement. Slipped capital femoral epiphysis scfe is a common hip. Obesity is a risk factor for developing slipped capital femoral epiphysis scfe.
Scfe is a common disorder in adolescents that can be frequently missed upon initial presentation. Complaints of groin, hip, thigh or knee pain similar to that of a muscle strain. This can be found here and is summarised in the following infographic. 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 slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. An abnormal klein line does not intersect the epiphysis, as the femoral neck has moved proximally and anteriorly relative to.
The modern, most used, frequently used term slipped capital femoral epiphysis or scfe, must be. Childrens orthopaedics the treatment of an unstable. Diagnosis can be made on ap and frog leg lateral radiographs. Epidemiology and demographics of slipped capital femoral. This is the growing portion or ball on the top part of the femur thigh bone. Its symptoms of vague pain in the groin or hip, or the thigh or knee, may be shared with. Proximal prolongation of the superior neck line transects the epiphysis in the normal hip right but either lies flush with or does not. Femoroacetabular impingement fai is associated with scferelated deformity and dysfunction in both short and long term. Slipped capital femoral epiphysis scfe hip joint, posterior and inferior slippage of proximal femoral epiphysis on the femoral neck metaphysis.
Although scfe is a rare condition, an accurate diagnosis combined with immediate treatment is critical. Between 1965 and 2005, 49 patients aged 916 years underwent treatment of scfe. 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. Pdf slipped capital femoral epiphysis researchgate. In scfe, the physis is not strong enough to withstand the shear forces acting on. The longterm outcome after scfe treatment depends on the severity of residual hip deformity and the occurrence of complications, mainly avascular necrosis avn. Sometimes it turns out to be a slipped capital or upper femoral epiphysis. For reasons that are not well understood, the ball at the upper end of the femur thigh bone slips off in a backward direction. Slipped capital femoral epiphysis dynamic chiropractic.
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. Patients typically present between 12 and 14 years of age. Online mendelian inheritance in man omim is a catalog of human genes and genetic disorders. Slipped capital femoral epiphysis scfe is a condition of the hip joint that affects children. Treatment of the slipped capital femoral epiphysis remains a cause of concern due to the fact that the true knowledge of the etiopathogeny is unknown, as well as one of its major complications.
Slipped capital femoral epiphysis or scfe is often not diagnosed until weeks or months after its onset. It is a fracture of the growth plate at the top of the femur. Slipped capital femoral epiphysis care in adolescents. Slipped capital femoral epiphysis images bmj best practice. Evolution of slipped capital femoral epiphysis after in situ screw. If we then combine these and say that if you have two or more areas of.
Scfe is often described as being like a scoop of ice cream slipping off the top of a cone. Can you join the military if youve had a slipped capital. The hip is a ballandsocket joint, which means that the rounded end of one bone in this case, the. There is no way to identify those children at risk for avn or to prevent this complication. The purpose of this study is to investigate the results of. The epidemiology and demographics of slipped capital femoral. Pdf analysis of the development of avascular necrosis in slipped. Pdf the etiology of slipped capital femoral epiphysis scfe is unknown with many insights. 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 normally, the head of the femur, called the capital, should sit squarely on the femoral neck. Slipped capital femoral epiphysis scfe is a condition affecting. Slipped capital femoral epiphysis in an adult with. Slipped capital femoral epiphysis linkedin slideshare. Avascular necrosis, slipped capital femoral epiphysis, stable slips. Scfe is more common in overweight children, and the incidence appears to be increasing.
The ball at the upper end of the femur thigh bone slips off in a backward direction. Each entry has a summary of related medical articles. Slipped capital femoral epiphysis differential diagnosis. Slipped capital femoral epiphysis scfe is an unusual disorder of the adolescent hip. Klein lines are drawn along the superior cortex of the femoral neck. Pdf the epidemiology and demographics of slipped capital. Slipped capital femoral epiphysis occurs during the adolescent growth spurt and is most frequent in obese children. Slipped capital femoral epiphysis in children health. Avn means that the blood supply to the femoral head has been permanently altered as a result of the femoral head slipping. Slipped capital femoral epiphysis, also known as scfe, is a hip problem that most frequently affects 1014 year old boys and 9 15 year old girls. Slipped capital femoral epiphysis in a hypothyroid adult male.
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