Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis

Adolescent Hip Condition : 10-16 (M>F)

• Slippage of overlying epiphysis on the growth plate of the femur (femoral head slips off neck of femur) — hip joint heals abnormally

  • during periods of rapid growth (puberty)

• Untreated = severe hip OA

SCFE - Presentation

• Hip, Groin, Medial Thigh and or Knee Pain

• Pain increases with activity

• Acute (trauma) or Insidious onset of a limp (gradual onset — no history of injury

• Decreased hip ROM : hip positioned ER with loss of IR

SCFE- Tests

X-ray

SCFE - Treatment

• Surgery : Epiphysis (Head of Femur) is screwed into place — stops head of femur from slipping any further :

  • Stable Slips = PWB to Tolerance x 6 weeks post-op

  • Unstable Slips = FWB x 6 weeks post-op

WB determined : type of slip, severity of slip, type of surgery performed

Stable Slip

• Stiffness/Pain — increases with activity or with rest

• Antalgic Gait

• Gait aid — crutches

PWB x 6 weeks post op

Unstable Slip

• Likely due to trauma and more painful — cannot walk or WB with gait aid

  • restriction of blood flow to hip joint = death of head of femur

  TTWB (FWB) x 6 weeks post op

SCFE PT Treatment

• ROM Exercises

• General Strengthening as tolerated — full return to sport and activity

SCFE

• Most common adolescent hip condition — most often seen b/w age 10-16 years old

• Caused by slippage of the overlying epiphysis on the growth plate of the femur

  • present with pain in the hip, groin, medial thigh, knee

• Pain increases with activity

• Often associated with a decreased ROM in the hip