slipped capital femoral epiphysis (SCFE)
introduction
SCFE is a hip condition where the ball of the hip joint slips from its position at the top of the femur. The process has been likened to how a scoop of ice cream slowly slips from a cone as is melts. We do not know why SCFE happens, but it is usually in large teenagers and the slip is actually occurring through the growth plate below the femoral head.
symptoms
Nearly all cases of SCFE are delayed in being diagnosed. Some reasons for this are that the child may feel the discomfort caused by the slip in the groin, thigh or knee. This can confuse everyone including health professionals. The key to diagnosing SCFE is simply to look for it in any adolescent with a limp, no matter where the discomfort is felt
treatmeant
The treatment of SCFE is urgent. This is because the slip is always progressive. As soon as the diagnosis is made all weight bearing on the leg should stop and the child be admitted to hospital.
When diagnosed early a simple operation done through a keyhole incision is performed to place a screw across the hip which prevents further slip. In some cases the "normal" side also needs this keyhole screw insertion to prevent a slip on that side.
More serious cases require an operation that re-positions the ball of the femur and the hip's muscle attachments back where they should be. Professor Little is an expert at all of these procedures.