It results in effect a slippage of the femoral head ball from the rest of the femur. Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10. It is separated from the main part of the bone by the growth plate. Your child has been treated for a condition of the hips called slipped capital femoral epiphysis ihpifihsis, or scfe skiffee. 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. Slipped capital femoral epiphysis scfe is a condition which predominantly occurs in adolescents. Slipped capital femoral epiphysis uf health, university of. This is usually an adolescent condition, more common in boys and the overweight. For reasons that are not well understood, the ball at the upper end of the femur thigh. The presentation is often subtle and clinicians need to bear the condition constantly in mind.
Slipped capital femoral epiphysis scfe is a wellknown disorder of the hip in adolescents that is characterized by translation of the upper femoral epiphysis from the metaphysis through the physis 1. 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. Mar 01, 2011 slipped capital femoral epiphysis in adults is uncommon, with only 10 cases reported in the literature. Slipped capital femoral epiphysis scfe is a shift at the upper part of the thighbone, or femur, that results in a weakened hip joint. Pdf slipped capital femoral epiphysis scfe is a common adolescent hip disorder. Slipped capital femoral epiphysis genetic and rare. Jun 12, 2019 slipped capital femoral epiphysis scfe was first described by ernst m u ller, who called it schenkelhalsverbiegungen im jungesalter, meaning. Slipped capital femoral epiphysis genetic and rare diseases. Scfe is extremely rare in adults, and nearly all previous reported cases have been. In this condition, the problem occurs in the upper area while the bone is still growing. But how attuned are we to this diagnosis, how common is scfe and what are the risk factors for it.
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. Open reduction of slipped capital femoral epiphysis nice. Feb 18, 2017 slipped upper femoral epiphysis sufe 1. Slipped capital femoral epiphysis, in situ screw fixation, femoroacetabular impingement. Slipped capital femoral epiphysis vamshi kiran feb 620 1. Slipped capital femoral epiphysis boston childrens hospital. Slipped upper capital femoral epiphysis sufe scfe slipped upper or capital femoral epiphysis sufe or scfe respectively predominantly affects adolescents.
It is like a fracture through the ballneck junction, but it behaves very differently. Slipped upper femoral epiphysis is a type i salterharris growth plate injury due to repeated trauma on a background of mechanical and probably hormonal predisposing factors. Feb 06, 20 slipped capital femoral epiphysis vamshi kiran feb 620 1. Slipped capital femoral epiphysis scfe is a condition affecting the hip joint. This can cause knee andor hip pain, limping and considerable deformity. 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.
If you or your child has suffered due to a delayed diagnosis or misdiagnosis, the experienced team at jmw can help you make a successful claim for compensation. Slipped capital femoral epiphysis treatment and surgery. Slipped upper femoral epiphysis radiology reference article. Slipped capital femoral epiphysis vamshi kiran feb 620. Although the disorder is called sufe, this term is technically incorrect. Slipped capital femoral epiphysis adolescent medicine. Slipped upper femoral epiphysis sufe is a condition of the hip that usually affects adolescents, in which the physis growth plate of the femur thighbone is weak and the epiphysis head part of bone becomes separated from the rest of the bone. This may occur suddenly acute or over a long period.
Childrens orthopaedics the treatment of an unstable. Slipped capital femoral epiphysis nationwide childrens. A slipped upper femoral epiphysis sufe is a known hip disorder in adolescents in which the proximal femoral epiphysis slips and displaces relative to the metaphysis. This can be found here and is summarised in the following infographic. Scfe may develop in one leg or it may occur in both legs. The modified dunn procedure for slipped capital femoral epiphysis.
Nov 02, 2016 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. Slipped capital femoral epiphysis in an adult with. Slipped capital femoral epiphysis scfe is defined as the femoral neck and femoral shaft top portions of the femur moving either posteriorly back, anteriorly forward or laterally to the side away from the femoral epiphysis and acetabulum the ball portion of the femur. Sufe is characterized by posterior and inferior displacement of the femoral head epiphysis, relative to the metaphysis. A child presenting with a chronic slipped upper femoral epiphysis sufe will generally walk with an antalgic gait, outtoeing and some shortening of the affected limb. Slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice. Scfe is the most common hip abnor mality in adolescence and is a major cause of early osteoarthritis.
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. Childrens orthopaedics the treatment of an unstable slipped. Dec 03, 2018 slipped capital femoral epiphysis scfe is one of the most important pediatric and adolescent hip disorders encountered in medical practice. Slipped capital femoral epiphysis differential diagnosis. Introduction and definition epidemiology and risk factors classification pathogenesis signs and symptoms diagnosis investigations management modalities complications. Jun 01, 2018 slipped capital femoral epiphysis slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. 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. Since 2000, four series have reported rates of avn between 0% and %, 811 although only the work of parsch 11 involved 30 patients. It is characterised by displacement of the capital femoral epiphysis from the metaphysis through the physis.
Hefny division of paediatric orthopaedics and limb reconstruction surgery, department of orthopaedic surgery, faculty of medicine. Slipped capital femoral epiphysis surgery treatment. Slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, occurring in 10. The red lines on the ap view represent kleins lines this is drawn along the superior aspect of the femoral neck normally it should pass through the epiphysis. Slipped capital femoral epiphysis uf health, university. Pdf the management of slipped capital femoral epiphysis. Slipped upper femoral epiphysis sufe is one of the most common causes of hip pain in adolescence. Pdf slipped capital femoral epiphysis researchgate. Slipped capital femoral epiphysis differential diagnoses. Fortunately, when caught early, most cases of scfe can be treated successfully. It involves weakness of the growth plate epiphyseal plate located at the top of the. Slipped upper femoral epiphysis scfe or sufe is a very common condition in the rapidly growing child. It is meant for health care professionals and researchers. 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.
It is one of commonest hip abnormalities in adolescence and is bilateral in around 20% of cases. Slipped capital femoral epiphysis scfe is a hip disorder that occurs in school children during the period of active growth between the ages of 10 and years. The proximal femoral growth plate is unstable and the epiphysis and diaphysis can slip out of the normal position, causing discomfort, pain or limping. Jun 15, 2017 slipped capital femoral epiphysis scfe is the most common hip disorder in adolescents, occurring in 10. This is a basic article for medical students and other nonradiologists. Slipped capital femoral epiphysis care in adolescents. The treatment of slipped capital femoral epiphysis scfe has been. A slipped capital femoral epiphysis is a developmental condition and type of femur fracture usually occurring in preteens and teens. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe is an unusual but not rare disorder of the adolescent hip. Diagnosis and treatment of slipped capital femoral epiphysis.
Slipped upper femoral epiphysis is not a frequent disease but it is potentially well treatable and early diagnosis is important. Slipped capital femoral epiphysis in adults is uncommon, with only 10 cases reported in the literature. Slipped capital femoral epiphysis scfe remember this song from when you were little. In undiagnosed hip, groin, thigh or knee pain, ap and frog lateral radiographs ideally after imhauser can be diagnostic or reassure a normal status. The full text of this article is available in pdf format. Slipped upper femoral epiphysis cardiff hip replacement. A slipped capital femoral epiphysis scfe results in the displacement of the femoral head, usually posteriorly and inferiorly in relation to the femoral neck and within the confines of the acetabulum.
Slipped capital femoral epiphysis scfe is an incapacitating orthopedic disease, particularly affecting older. Treatment options depend on the severity of the slip. Scfe usually occurs in those eight to 15 years of age and is one of. Slipped capital femoral epiphysis slipped capital femoral epiphysis surgery imaging in slipped capital femoral epiphysis. Childhood obesity and slipped capital femoral epiphysis. A scfe can be either unilateral one side or bilateral both sides. Slipped capital femoral epiphysis scfe for parents. Rarely, children as young as six or seven can be affected and. With this injury, the ball of the femur, also known as the epiphysis, slips backward off the neck of the femur bone at the growth plate. Slipped capital femoral epiphysis scfe is a rare condition that is slightly more likely to occur in boys than girls.
A slipped upper femoral epiphysis sufe is a condition involving the hip joint. Surgery was done to help keep the head and neck of the femur bone the long bone in. Screw placement in slipped upper femoral epiphysis. The child may complain of vague pain in the groin, thigh or knee. A scfe occurs when the physis is unable to hold the femoral head and neck together. Slipped upper femoral epiphysis is a rare hip disorder in adolescents that can result in serious injury and a permanent limp if not detected early enough. A good, stable connection at your hip joint is what lets you walk, run, make that jump shot, and shake it.
In scfe, the physis in the head of the femur thigh bone becomes loose. Femoroacetabular impingement fai is associated with scferelated deformity and dysfunction in both short and long term. Feb 27, 2019 please use one of the following formats to cite this article in your essay, paper or report. Slipping of the upper femoral epiphysis is most often observed in children between 10 and 16 years of age and is more common in boys than girls. The endocrine basis for slipping of the upper femoral. The displacement occurs at the level of the hypertrophic zone of the physeal cartilage. It is one of the commonest hip abnormalities in adolescence and is bilateral in 20% of cases. This may occur suddenly acute or over a long period of time chronic. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, is a relatively common condition affecting the physis of the proximal femur in adolescents. Please use one of the following formats to cite this article in your essay, paper or report. Obesity is a risk factor for developing slipped capital femoral epiphysis scfe. In the hip joint, the femur also known as thigh bone is composed of the femoral head and neck, with the physis also known as growth plate forming a junction between these two.
The upper femoral epiphysis is held in the acetabulum by the ligamentum teres, and the femoral metaphysis displaces on the femoral head, leading to the child presenting with a painful hip of gradual or acute onset. Slipped capital femoral epiphysis scfe is a hip problem that starts if the epiphysis growing end of the femur thigh bone slips from the ball of the hip joint. Sometimes it turns out to be a slipped capital or upper femoral epiphysis. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, is a relatively common condition affecting the physis of the. The epiphysis is the end of a long bone and is joined to the bone at the growth plate physis. Slipped capital femoral epiphysis scfe is an orthopedic condition of children and adolescents. Here it does not on the left, giving the diagnosis of sufe. Slipped upper femoral epiphysis sufe is a well recognised disorder of adolescent hips. Slipped upper femoral epiphysis scfe or sufe hip conditions. Slipped upper femoral epiphysis sufe is one of the common causes of hip pain in adolescence 1. Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. Delay in diagnosis of slipped upper femoral epiphysis. As a result, the epiphysis separates from the rest of the bone and the femur moves out of alignment in the hip joint. 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.
It usually occurs in children eight to 15 years of. Untreated sufe tends to progress, with increasing risk of hip deformity and osteoarthritis. This helps to make the diagnosis on the ap view as findings are often subtle. Although scfe is a rare condition, an accurate diagnosis combined with immediate treatment is critical. Online mendelian inheritance in man omim is a catalog of human genes and genetic disorders. Slipped upper femoral epiphysis sufe is a common hip disorder of adolescence. Slipped capital femoral epiphysis scfe is a hip condition that occurs in teens and preteens who are still growing. Slipped capital femoral epiphysis scfe slipped capital femoral epiphysis scfe, a relatively common disorder in childhood, occurs most commonly between age 814 years. If slipped upper femoral epiphysis is confirmed on imaging, the child should be rested, admitted, and not allowed to weightbear. 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. Well, the song may be silly, but one thing is true. Perry et al looked at these questions using a cohort study over 23 years. Slipped capital femoral epiphysis scfe also known as slipped upper femoral epiphysis sufe is a disorder involving the hip joint.
Surgical hip dislocation in treatment of slipped capital. Slipped capital femoral epiphysis scfe is a common hip disorder in children and adolescents, and it consists in posteroinferior migration of the. Slipped upper femoral epiphysis sufe, also known as a slipped capital femoral epiphysis scfe, plural. Each entry has a summary of related medical articles. The epiphysis is located at the top of the femur, and the femoral head will usually slip. Jan 23, 2015 a slipped capital femoral epiphysis scfe results in the displacement of the femoral head, usually posteriorly and inferiorly in relation to the femoral neck and within the confines of the acetabulum. Slipped upper femoral epiphysis sufe presented by siti nur rifhan kamaruddin 2. Orthospecialist slipped upper femoral epiphysis sufe. It involves weakness of the growth plate epiphyseal plate located at the top of the femur thigh bone causing the head of the femur to slip backwards and downwards. High survivorship and little osteoarthritis at 10year followup in.
Pdf the treatment for most patients with slipped capital femoral epiphysis scfe is well established but controversy remains as to how to. Slipped upper femoral epiphysis sufe emergency department. Slipped capital femoral epiphysis scfe remains the most common adolescent hip disorder 15. Evolution of slipped capital femoral epiphysis after in situ screw. Delayed presentation or diagnosis can lead to severe changes and risk of early. Diagnostic and therapeutic challenges of a slipped capital. A slipped capital femoral epiphysis may affect both hips. Definition displacement of the proximal femoral epiphysis is uncommon and usually confined to children going through the pubertal growth spurt. Slipped upper femoral epiphysis sufe in sufe, the femoral neck subluxes away from the epiphysis which can result in a severely altered geometry of the hip and sometimes catastrophic avascular necrosis.
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