1. SCFE Is a Disorder of the Adolescent Hip
SCFE (pronounced "skiff-ee") stands for slipped capital femoral epiphysis. "Slipped" means the bone has slid off the growth plate. "Capital" means the head. The femoral epiphysis is the top part of the thigh bone--the top part of the ball that forms the ball-and-socket joint of the hip. Taken together, SCFE is a condition in which the top part of the femur bone slips off the growth plate. Think of it as the ice cream falling off the cone.
2. It Commonly Happens in Overweight Males
SCFE is two to three times more common in males than in females. Being overweight is a risk factor: If more stress is being put on the growth plate, the bone may slip off more easily. Other factors that can affect the growth plate can also contribute to having an SCFE. Children with endocrine problems, such as diabetes, are at risk. Thyroid disorders and other hormonal problems can also lead to an SCFE.
3. It Slips Posterior and Inferiorly
Because of the direction of the slip, the hip no longer has full motion. The hip will lose internal rotation. This can be seen as the foot turning outward. It is even more pronounced as the hip is flexed. The knee will roll to the side and the foot will point outward, because of the obligate external rotation.
4. Stay Off It
The sufferer may have either hip or knee pain; that pain can be activity-related or can be present even at rest. Again, the foot may be turned outward, especially as the hip is flexed. The affected side may become shorter than the other side. If you see any of these symptoms, seek medical attention and obtain crutches. By keeping weight off the hip, you can prevent further slipping of the bone.
5. Surgery May Be Required
As the bone slips, there is greater loss of motion and further disability. Therefore, the goal of surgery is to prevent further deformity. A small incision is made on the front of the thigh. A single screw is placed into the center of the femoral epiphysis to help stabilize the bone until the growth plate fuses. The earlier the SCFE is caught, the better the residual outcome. Larger deformities can lead to future problems, such as femoroacetabular impingement (FAI).
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