Slipped capital femoral epiphysis (SCFE)

Disclaimer: This fact sheet is for education purposes only. Please consult with your doctor or other health professional to make sure this information is right for your child.

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What is SCFE?

SCFE is a condition that affects the hips of older children and teenagers. At the top of the femur (the thigh bone) is a ball-shaped area (the femoral head).  The hip is a ball and socket joint and the ball of the femur is connected to the top of the femur by a growth plate.  As the growth of the femur slows down, the ball can become unstable and slip. If this occurs it can cause the leg to turn outwards by changing the shape at the top of the femur.  This can affect how the hip moves. Some children with SCFE may have a pain in the thigh or knee rather than their hip. This is called referred pain.

What is the cause?

The condition affects boys and girls equally. There is thought to be a link between:  children and adolescents who are not within a healthy weight range,, the shape and position of the femur (called retroversion),puberty and hormones and endocrine conditions.

What problems will occur?

If SCFE is not treated, it will become worse, and may lead to arthritis in the hip. Treatment helps to reduce the risk of later arthritis.

What treatment will be needed?

Your child will require surgery to stabilize the hip. One or two screws will be screwed into the ball of the femur to prevent further movement (shown in the picture below). This can be done through a very small cut.

Your child will have a short stay in hospital and their hip will feel better straight after surgery. Your child will need to move around on crutches for the next six weeks while the hip heals.

Some children with SCFE may develop SCFE on the other hip. The other hip will be monitored and operated on if there is a suspicion of SCFE.

After surgery, the screws are not removed unless a complication develops. They should not be removed before your child stops growing.

Some children have a more acute condition called unstable SCFE. This condition carries the added risk of an injury to the femoral head blood supply and will require more complex treatment, as will severe cases of chronic SCFE. Your doctor will discuss this with you if it applies to your child.

Remember

  • Children with SCFE need surgery but usually lead full active lives after their hips have healed.
  • SCFE can occur later on the other side. If the other hip is hurting see your doctor straight away.
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The Children's Hospital at Westmead
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Sydney Children's Hospital, Randwick
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Hunter New England Kids Health
www.hnekidshealth.nsw.gov.au

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