Slipped Capital Femoral Epiphysis

Limping in 10-15 years: A slipped capital femoral epiphysis occurs when what plate of what structure is weak? then becomes what?

When the growth plate of the proximal femoral epiphysis is weak and becomes displaced (slips down) from its normal position

what is the exact cause of slipped capital femoral epiphysis?

what 2 factors are likely?

1. exact cause is unknown

2. endocrine and mechanical factors are likely

what is the incidence rate of slipped capital femoral epiphysis?

in which gender?

1. 10.8 per 10,000

2. M>F with 2-3:1 ratio

Clinical manifestations for slipped capital femoral epiphysis:

• onset in who and when?

• what side involvement in how many cases?

• early presentation is what associated with what pain?

  • referred to what side and of what 2 body parts?

• what is the motion limitation? (3)

• Onset in boys usually at puberty (10-16 in males, 9-15 in females)

• B/L involvement occurs in 1/4 to 1/3 of cases

• early presentation = limp w/ groin pain, referred to anteromedial side of thigh and knee

• Motion limitation in hip flexion, abd, and IR

Clinical Manifestations: Radiographs demonstrate what displacement? in what direction?

• what is the limitation of anterior view?

Initial displacement in a posterior and inferior direction

• may be missed on an anterior view x-ray

Treatment for SCFE:

• goals to maintain ___, keep ___ to a minimum if not a severe case, prevent early ___

• _____ using screw or pins in severe, ___, or progressing cases

  • be aware of what?

1. Maintain ROM, keep displacement to a minimum if not a severe case, prevent early degenerative arthritis

2. Surgical fixation using screw or pins in severe, unstable, or progressing cases

   • be aware of avascular necrosis