Slipped capital femoral epiphysis | |
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Other names | Slipped upper femoral epiphysis (SUFE), coxa vara adolescentium, skiffy, souffy |
X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. | |
Specialty | Orthopedics |
Symptoms | Groin, hip, knee, or thigh pain, limp[1] |
Usual onset | 8 to 15 years old[1] |
Types | Stable, unstable[1] |
Risk factors | Obesity, hypothyroidism, hypogonadism[1] |
Diagnostic method | Hip X-rays[1] |
Differential diagnosis | Adductor muscle strain (groin pull), transient synovitis, Legg-Calvé-Perthes disease, septic arthritis, avulsion fracture[1] |
Treatment | No weight on affected leg, surgery[1] |
Frequency | 1 per 10,000 children[1] |
Slipped capital femoral epiphysis (SCFE), also known as a skiffy, is a fracture through the growth plate, which results in slippage of the underlying femoral neck.[1] Symptoms generally include a limp and pain in the groin, hip, thigh, or knee.[1] Ability to fully move the affected hip may also be decreased.[2] Both sides may be affected in 20% to 50% of cases.[1] Complications may include avascular necrosis, chondrolysis, and femoroacetabular impingement.[1]
Risk factors include obesity, hypothyroidism, and hypogonadism.[1] Diagnosis is by Xraying both hips.[1] They are divided into two types: stable and unstable.[1] It is mild if the slip is less than a third, moderate if between a third and a half, and severe if greater than a half.[1] If the diagnosis is delayed a worse outcome may result.[1]
Treatment is generally by surgery.[1] Until this can be carried out the person should put not weight on that leg.[1] SCFE affects 11 per 100,000 children and in adolescents is the most common hip disorder.[1] It generally occurs in those 8 to 15 years old and is more common in males.[1] With rising rates of obesity in children the disease is becoming more common.[2] The condition has been described since at least 1572.[3]
References
edit- ^ a b c d e f g h i j k l m n o p q r s t u Peck, DM; Voss, LM; Voss, TT (15 June 2017). "Slipped Capital Femoral Epiphysis: Diagnosis and Management". American family physician. 95 (12): 779–784. PMID 28671425.
- ^ a b Karkenny, AJ; Tauberg, BM; Otsuka, NY (September 2018). "Pediatric Hip Disorders: Slipped Capital Femoral Epiphysis and Legg-Calvé-Perthes Disease". Pediatrics in review. 39 (9): 454–463. doi:10.1542/pir.2017-0197. PMID 30171056.
- ^ Shapiro, Frederic (2002). Pediatric Orthopedic Deformities. Elsevier. p. 379. ISBN 978-0-08-053856-3. Archived from the original on 2021-08-29. Retrieved 2020-10-11.