Slipped Growth Plate in Hip (Slipped Capital Femoral Epiphysis)

What is slipped capital femoral epiphysis?

Slipped capital femoral epiphysis (SCFE) is a bone disorder that affects the hip joint. The hip joint is a ball and socket joint. The socket is a part of your hip bone, and the ball part of the joint is the top end of the thigh bone. The ball part of the joint is called the epiphysis. The bone grows from an area called a growth plate, just below the epiphysis. When a child has SCFE, the growth plate slips, which means that the ball and socket do not line up properly.

This problem is common in teens. It is more common in boys than in girls. It is also more common in children who are very overweight or who are growing rapidly.

What is the cause?

SCFE usually happens when a child’s bones are growing quickly during the early teens. Weakness in the growth plate causes the epiphysis to slip off the rest of the thigh bone. Doctors don’t know what causes the weakness. It may happen in both hips.

What are the symptoms?

Common symptoms include:

• hip or knee pain that lasts for weeks or months
• pain on the inside of the knee or in the groin
• limping
• one leg that looks shorter or is turned out more than the other leg
• trouble putting weight on the leg

How is it diagnosed?

Your healthcare provider will watch your child walk and move the hip. The provider will check to see if:

• Your child can turn the hip inward.
• Your child can lift the knee and hip toward the chest.
• Your child has extreme pain when he or she moves the hip.

Your child may have X-rays of the hip.

How is it treated?

It is important to catch and treat SCFE early. Usually it is treated with surgery. There are different ways the surgery may be done. Screws may be used to hold the bones in place, or part of the growth plate may be removed.

After surgery your child will need to use crutches for weeks to months. Your child will have regular appointments with your healthcare provider for the next 18 to 24 months. Your provider will take X-rays to watch the growth plate. Your child may need to limit some sports and other activities until your child is done growing and the growth plate closes.

If SCFE is not treated, the end of the thigh bone may be destroyed by a lack of blood flow or your child may permanently lose full motion of the hip joint.

How can I help take care of my child?

• Make sure your child gets exercise for his or her upper body and core—like sit-ups, push-ups, or upper body weight training with light weights.
• Keep your child healthy, interested, and motivated in sports and fitness.
• Ask your child’s healthcare provider about using an ice or gel pack to keep your child comfortable.
• Give pain medicine, such as ibuprofen, as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.

How can I help prevent SCFE?

In many cases SCFE is not preventable. However, many children with SCFE are overweight. The extra weight puts more stress on the growth plate in the thigh bone at the hip. Losing weight may help relieve some of the pressure and help prevent SCFE.