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Slipped Capital Femoral Epiphysis Guide

This document discusses slipped capital femoral epiphysis (SCFE), a condition where the femoral head slips out of place from the femoral neck during adolescent growth. SCFE most commonly affects obese males between 10-16 years old and can be bilateral in up to 80% of cases. Risk factors include increased physeal height and inclination, endocrine disorders like hypothyroidism, and certain genetic conditions. Imaging like x-rays can diagnose SCFE by identifying signs like Klein's line and Capener's sign. Treatment involves internal fixation of the slipped capital femoral epiphysis to allow healing in the proper position, with risks of complications like avascular necrosis and osteoarthritis if not addressed.

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58 views12 pages

Slipped Capital Femoral Epiphysis Guide

This document discusses slipped capital femoral epiphysis (SCFE), a condition where the femoral head slips out of place from the femoral neck during adolescent growth. SCFE most commonly affects obese males between 10-16 years old and can be bilateral in up to 80% of cases. Risk factors include increased physeal height and inclination, endocrine disorders like hypothyroidism, and certain genetic conditions. Imaging like x-rays can diagnose SCFE by identifying signs like Klein's line and Capener's sign. Treatment involves internal fixation of the slipped capital femoral epiphysis to allow healing in the proper position, with risks of complications like avascular necrosis and osteoarthritis if not addressed.

Uploaded by

drprasant
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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Slipped Capital Femoral

Epiphysis
(SCFE)
Leonel Copeliovitch M.D.
Assaf Harofe Medical Center

SCFE
Antero-lateral displacement of the
femoral neck from the epiphysis
Occurs during adolescent growth
spurt
Bilateral in 10 to 80% of cases
More common on the left than the
right
Affects 1 3 per 100,000 people

SCFE
Males: 60%, Females:40% of the
cases
Obese child(2/3) or rapidly growing
tall adolescent(1/3)
In 5% , parents with SCFE

SCFE- Risk Factors


Physeal height
Planar physis
Load
Abnormal physeal inclination
Deficient physeal components

SCFE- disorders associated


Endocrine :cryptorchidism,
hypothyroidism, adiposogenital
syndrome, acromegaly, growth
hormone therapy
Genetic: Kleinfelter, Down, Marfan
Metabolic: Rickets, renal
osteodystrophy

SCFE- Pathology
Slip occur between proliferative
and hypertrophic zones
Physeal fracture occurs between
hypertrophic and calcification
zones

SCFE- Clinic
Stable, unstable
Limp- Trendelenburg
Limitations: abduction, internal
rotation and flexion
Pain: groin, thigh or knee
Limb shortening: 1 2 cm

SCFE- Imaging
X ray: AP, FROG
Kleins line, Capeners sign
Ultra sound
Bone scan

SCFE- classification
Acute
Chronic
Acute on chronic

SCFE- grading
Till 30%
30% to 60%
Over 60%

SCFE- treatment
Internal fixation in situ
Manipulation and internal fixation
Osteotomies: Dunn, Southwick

SCFE- complications
Avascular necrosis (AVN)
Chondrolysis
Residual deformity
Osteoarthritis

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