Slipped capital femoral epiphysis

Definition

A slipped capitol femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone.

Causes, incidence, and risk factors

A slipped capitol femoral epiphysis is a condition that is most common in growing children, especially between ages 11 and 15. This disease may affect both hips.

An epiphysis is an area at the end of a long bone that is separated from the main part of the bone by the physeal plate (growth plate). In this condition, a displacement occurs in the upper epiphysis while the bone is still growing.

This condition is more common in boys, in children who are obese, and in children who are growing rapidly. Children with hormone imbalances caused by other conditions are at particular risk for this disorder.

Symptoms

• Knee pain
• Hip pain
• Outward-turning leg
• Restricted hip movements
• Hip stiffness
• Difficulty walking, walking with a limp

Signs and tests

During a physical examination, the doctor will look for restricted hip motion and pain with attempted hip movement. A hip or pelvis x-ray shows displacement.

Treatment

Surgery to stabilize the bone with pins or screws will prevent further slippage or displacement of the ball of the hip joint. Some surgeons may offer to pin the unaffected hip at the same time, because many children will develop a slip of this hip as well.

Expectations (prognosis)

The outcome is usually good with treatment. However, in rare cases, the hip joint may degenerate. Most experts agree that this is due primarily to a displacement of the growth plate, followed by a disruption of the blood supply to the ball of the hip. Because this is related to the severity of the condition itself, the joint may degenerate despite prompt recognition and treatment.

Complications

This disorder is associated with a greater risk of osteoarthritis later in life. Other potential but rare complications include diminished blood flow to the hip joint and thinning of the cartilage in the hip joint.

Calling your health care provider

If your child experiences persistent pain or other symptoms suggestive of this disorder, have the child lie down immediately and remain still until medical attention has been obtained.

Prevention

Weight control for obese children may be helpful. Many cases are not preventable.

Illustrations

Femoral fracture

Page Content:

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