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From the American Academy of Orthopaedic Surgeons

Musculoskeletal Effects of Down Syndrome

Slipped Capital Femoral Epiphysis

by Elizabeth Weber, MD; Ryan Naujoks, MD; Brian G. Smith, MD

Slipped capital femoral epiphysis (SCFE) is a common hip disorder in adolescents and is characterized by posteroinferior displacement of the capital femoral epiphysis on the metaphysis through the physis. Symptoms of SCFE at presentation include hip, groin, and knee pain. Ambulatory patients may also present with a limp. SCFE is classified as stable when the patient can walk on the involved extremity and unstable when the patient cannot walk, with or without crutches. The standard of care for both stable and unstable SCFE is in situ percutaneous single-screw fixation, and this treatment has a high probability of success. An additional screw confers more strength, but carries a higher complication rate. For patients with severe SCFE, removal of the femoral neck prominence in combination with a valgus derotational osteotomy can restore a good range of motion and provide a satisfactory weight-bearing surface.

Keywords: SCFE, slipped upper femoral epiphysis, hip disorder, slipped hip, adolescent hip disorder, femoral head displacement, Salter-Harris physeal fracture, Salter-Harris fracture, hip pain, hip joint pain

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