However spontaneous stress fractures of the femoral neck in older patients are rare and bilateral fractures have not been documented before. This part of the bone is where the leg grows new bone and is known as a growth plate. The goal of initial treatment is to prevent further slippage of the epiphysis. Please consult with your doctor or other health professional to make sure this information is. 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 capital femoral epiphysis in an adult patient with. Slipped capital femoral epiphysis scfe for parents.
Slipped capital femoral epiphysis slipped capital femoral epiphysis is a condition of the hip that primarily affects adolescents. It is meant for health care professionals and researchers. Skeletal immaturity is evident in radiographic imaging by the presence of a growth plate, or physis. Scfe is more common in overweight children, and the incidence appears to be increasing. Slipped capital femoral epiphysis scfe is a salterharris type i fracture through the physeal plate of the proximal femur resulting in displacement. Slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, occurring in 10. Slipped capital femoral epiphysis scfe is a disease of the growth plate physis that causes profound lifelong disability and is believed to be caused by obesity. 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. While each of us has a foolproof method of managing the disease, we also have somewhere in our files a patient with a disastrous outcome. What complications can occur in patients with slipped capital femoral epiphysis. Article childhood obesity and slipped capital femoral epiphysis daniel c. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Pdf the management of slipped capital femoral epiphysis. The physis is the active area of skeletally immature bones which allows length to be added to that bone. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, plural. It is characterised by displace ment of the capital femoral epiphysis. Patient underwent surgery to fixate in may and was referred to physical therapy 3 months later. Slipped upper femoral epiphysis radiology reference.
It is a fracture of the growth plate at the top of the femur. Symptoms epifisjolisis pain, referred knee and thigh pain, waddling gaitrestricted range of motion of leg usual onset adolescence risk factors obesityhypothyroidism slipped capital femoral epiphysis scfe or skiffyslipped upper femoral epiphysissufe or souffycoxa vara adolescentium is a medical term. Clinicians should understand when to suspect these disorders based on history, examination, and early imaging findings to allow for timely referral to a specialist. Introduction slipped capital femoral epiphysis scfe is a condition that affects the hip in teenagers between the ages of 12 and 16 most often. Slipped capital femoral epiphysis scfe is a hip condition that occurs in teens and preteens who are still growing. Slipped capital femoral epiphysis genetic and rare. 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. Factors affecting outcomes of slipped capital femoral. Slipped capital femoral epiphysis scfe is a commonly encountered hip disorder.
Start studying slipped capital femoral epiphysis scfe. Major complications are avascular necrosis and chondrolysis. In mild forms, both stable and unstable, in situ fixation is widely. Slipped capital femoral epiphysis, is a common hip disorder in adolescence, in which the growth. Risk factors for readmission after surgical treatment of. Slipped capital femoral epiphysis differential diagnosis. Slipped capital femoral epiphysis scfe is believed to be associated with childhood obesity, although the strength of the association is unknown. The epidemiology and demographics of slipped capital. Slipped capital femoral epiphysis sydney childrens hospital. 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. Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10. Diagnosis and treatment of slipped capital femoral epiphysis. A slipped capital femoral epiphysis is one of the most common reasons for a painful hip in older and teenage children adolescents. Slipped capital femoral epiphysis scfe is considered the most common adolescent hip disorder.
It is twice as common in males 1215 years than females 10 years. Slipped capital femoral epiphysis slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. Avascular necrosis is a serious complication that occurs in patients with severe slippage. For reasons that are not well understood, the ball at the upper end of the femur thigh bone slips off in a backward direction due to weakness of the growth plate. Slipped capital femoral epiphysis scfe is an condition of the proximal femoral physis that leads to slippage of the metaphysis relative to the. Slipped capital femoral epiphysis scfe flashcards quizlet. Pdf the treatment for most patients with slipped capital femoral epiphysis scfe is well established but controversy remains as to how to. Slipped capital femoral epiphysis scfe sydney children. As mentioned above, a slipped capital femoral epiphysis is more common in children who are overweight or obese. Slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, usually occurring between eight and 15 years of age. The treatment of slipped capital femoral epiphysis scfe in adolescents remains controversial. Pdf surgical hip dislocation in treatment of slipped.
Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is an unusual but not rare disorder of the adolescent hip. 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. Pdf prediction of contralateral slipped capital femoral. However, caution is required because recent studies have reported a high rate of complications including postoperative femoral head avascular necrosis avn. It should be suspected in any adolescent who complains of hip or knee pain. This report describes one case of bilateral stress fracture of the femoral neck in an elderly patient and its surgical. Scfe is a condition that affects the top of the femur thighbone of older children and teenagers. Orthopedics slipped capital femoral epiphysis scfe is a common, surgically treated adolescent hip condition. Slipped capital femoral epiphysis scfe or slipped upper femoral epiphysis, sufe describes a type of break or fracture through the ball part of the ball and socket which forms the hip joint. A patients guide to slipped capital femoral epiphysis compliments of.
Hefny division of paediatric orthopaedics and limb reconstruction surgery, department of orthopaedic surgery, faculty of medicine. It is characterised by displacement of the capital femoral epiphysis from the metaphysis through the physis. Slipped upper femoral epiphysis iis windows server. The top part of the thighbone is shaped like a ball femoral head.
To understand scfe, it helps to know a little about what the hip joint looks like. The goal of this study was to describe the incidence of missed contralateral scfe as well as to identify risk factors. A slipped upper femoral epiphysis sufe is a condition involving the hip joint. This study sought to evaluate postoperative complications and factors associated. Its symptoms of vague pain in the groin or hip, or the thigh or knee, may be shared with. Abnormal movement along the growth plate results in the slip. Background the purpose of the present study was to determine whether the modified oxford bone score can be used as a predictor for the risk of developing contralateral slipped capital femoral epiphysis scfe in children who present with a unilateral slip. Although the disorder is called sufe, this term is technically incorrect. It is the weaker area of the bone during the adolescent years when children are still growing. Most scfes are varus medial and posterior epiphyseal displacement relative to the metaphysic but can occasionally be valgus lateral and superior epiphyseal displacement 1 4. Slipped capital femoral epiphysis is a common malady which must be managed by virtually every orthopedic surgeon. Methods we identified 260 patients treated for unilateral scfe between 1980 and 2002 and followed them up to skeletal maturity or until. It is one of the commonest hip abnormalities in adolescence and is.
Slipped femoral epiphysis twin boro physical therapy. The etiology of scfe includes biomechanical and biochemical factors. Slipped capital femoral epiphysis cleveland clinic. Slipped capital femoral epiphysis scfe is a common hip disorder in children and adolescents, and it consists in posteroinferior migration of the. Slipped capital femoral epiphysis or scfe is often not diagnosed until weeks or months after its onset. Slipped capital case study femoral epiphyses alterg. Scfe is extremely rare in adults, and nearly all previous reported cases have been associated with an endocrine disorder.
Cases have been reported as early as age nine years old. To understand scfe, it helps to know a little about the hip joint. Perry, phd,a, b, c david metcalfe, mbchb,c steven lane, phd,a steven turner, mdd background. 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. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is a disorder in which the femoral head ball of the thigh bone slips off the neck of the femur thigh bone though the growth plate. Bilateral stress fractures of the femoral neck from renal. Slipped capital femoral epiphysis scfe remains the most common adolescent hip disorder 15. It usually occurs in children eight to 15 years of age. Slipped capital femoral epiphysis scfe is a common adolescent hip disorder. Valgus slipped capital femoral epiphysis valgus scfe is an uncommon form of scfe, with lateral or posterolateral displacement of the epiphysis. Slipped capital femoral epiphysis scfe is an adolescent hip disorder with displacement of the capital femoral epiphysis from the metaphysis through the physis. Scfes are classified as stable and unstable and are more common in boys than girls and in certain racial groups.
Patient wants to return to high school sports of basketball, football, and baseball. Online mendelian inheritance in man omim is a catalog of human genes and genetic disorders. In this condition, the growth center of the hip the capital femoral epiph. Scfe is the most common hip disorder in adolescents, usually occur ring between eight and 15 years of. This may occur suddenly acute or over a long period. Surgical hip dislocation in treatment of slipped capital femoral epiphysis article pdf available february 2017 with 280 reads how we measure reads. Pdf surgery for slipped capital femoral epiphysis in. Childhood obesity and slipped capital femoral epiphysis.
Slipped upper femoral epiphysis sufe is a well recognised disorder of adolescent hips. Normally, the head of the femur, called the capital, should sit squarely on the femoral neck. 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 is a frequent cause of a nontraumatic painful hip of the adolescence 1,2. Each entry has a summary of related medical articles. Scfe is the most common hip abnor mality in adolescence and is a major cause of early osteoarthritis. The femoral neck metaphysis rotates externally and migrates anteriorly and proximally relative to the proximal femoral epiphysis, which is stably seated in the acetabulum. 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. The term slipped capital femoral epiphysis is actually a misnomer, because the epiphysis remains in.
Slipped capital femoral epiphysis scfe is an condition of the proximal femoral physis that leads to slippage of the metaphysis relative to the epiphysis, and is most commonly seen in adolescent obese males. Pdf slipped capital femoral epiphysis researchgate. Pdf slipped capital femoral epiphysis scfe is a common adolescent hip disorder. Slipped capital femoral epiphysis management and treatment. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe, a relatively common disorder in childhood, occurs most commonly between age 814 years.
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