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Slipped capital femoral epiphysis (SCFE)
Terms in this set (8)
Separation of the proximal femoral epiphysis through the
to medial and posterior displacement of the femoral head (relative to thefemoral neck). May be due to an imbalance between growth hormone and sex hormones.
-Separation through growth plate of femoral epiphysis from metaphysis
-Risk factors = adolescent, obese, black race, hypothyroidism
Obesity is the mainly risk factor
Risk factors: include
, age 11-13, male gender, and African-American ethnicity.
Associated with hypothyroidism and other endocrinopathies.
H/P = thigh and knee pain; limp, limited internal rotation and abduction of the hip, hip flexion produces obligatory external hip rotation
Hint: Obesity, limp, adolescent Think!! "Slipped capital femoral epiphysis"
■ Typically presents with acute or insidious thigh or
knee pain and a painful limp.
■ Acute cases present with restricted ROM and, commonly,
inability to bear weight.
■ Bilateral in 40-50% of cases.
■ Characterized by limited internal rotation and abduction of the hip. Flexion of the hip results in an obligatory external rotation 2° to physical displacement that is observed as further loss of internal rotation with hip flexion.
a. x-rays indicate posterior and medial displacement of the femoral head from the femoral metaphysis
■ Radiographs of
both hips in AP and frog-leg lateral views
s* reveal posterior and medial displacement of the femoral head
■ Rule out hypothyroidism with TSH.
b. weight -bearing restrictions prior to repair if unstable (unable to bear -weight on presentation
c. prophylactic pinning of normal contralateral side performed in cases of hypothyroidism
(Closed reduction of acute slips prior to pinning is controversial)
Complications = increased risk of avascular necrosis (AVN) and premature osteoarthritis if treatment is not performed early
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