Slipped Capital Femoral Epiphysis Fundamentals

Slipped Capital Femoral Epiphysis (SCFE) is one of the hip conditions that occur in children who are still growing. The epiphysis is the end of a bone that lies between the joint surface and the epiphyseal plate. It is separated from the main shaft of the bone by a soft, flexible layer of cartilage where new bone is formed. In SCFE, the head of the thighbone (femur) slips off the neck of the bone at the growth plate, the weaker area of the bone that has not yet developed. Usually, the leg turns out and the neck of the thighbone moves forward.

The condition, which can occur in one or both hips, develops gradually. Typically, SCFE occurs in overweight children between 11 and 16 years old and is more common among boys. Additionally, it occurs more often among African Americans than Caucasians.

Serious complications can occur as a result of SCFE. Chondrolysis, or rapid destruction of cartilage in the hip joint, is one complication. In addition, and perhaps most dangerous, is the chance that the slipping femoral head will lose its blood supply. In this case, the bone of the hip may die and collapse, resulting in rapid and severe arthritis. Fortunately, with early diagnosis and careful surgical management, these hip complications can usually be avoided.

What are the symptoms of hip conditions?

  • Pain in the groin, knee or thigh
  • Limping
  • Stiffness in the hip
  • Rotated foot
  • One leg may appear shorter than the other

More severe cases of hip conditions are accompanied by extreme pain and the inability to move the affected leg.

What are my child’s treatment options?

To diagnose the condition, your doctor will most likely order X-rays of both hips.

If diagnosed with SCFE, your child will need hip surgery. The most common type of surgery is "in-situ fixation." In this procedure, the surgeon uses a screw to close the growth plate to prevent the thigh bone from slipping. "Pinning" the head of the femur (the epiphysis) in place is necessary to stabilize the growth plate. Typically, the outcomes are excellent with few, if any, complications.