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Slipped capital femoral epiphysis

Femoral epiphysis - slipped

 

A slipped capital femoral epiphysis is a separation of the ball of the hip joint from the thigh bone (femur) at the upper growing end (growth plate) of the bone.

Causes

 

A slipped capital femoral epiphysis may affect both hips.

An epiphysis is an area at the end of a long bone . It is separated from the main part of the bone by the growth plate. In this condition, the problem occurs in the upper area while the bone is still growing.

Slipped capital femoral epiphysis occurs in about 2 out of every 100,000 children. It is more common in:

  • Growing children ages 11 to 15, especially boys
  • Children who are obese
  • Children who are growing rapidly

Children with hormone imbalances caused by other conditions are at higher risk for this disorder.

 

Symptoms

 

Symptoms include:

  • Difficulty walking , walking with a limp
  • Knee pain
  • Hip pain
  • Hip stiffness
  • Outward-turning leg
  • Restricted hip movements

 

Exams and Tests

 

The health care provider will examine you. A hip or pelvis x-ray can confirm this condition.

 

Treatment

 

Surgery to stabilize the bone with pins or screws will prevent the ball of the hip joint from slipping or moving out of place. Some surgeons may suggest using pins on the other hip at the same time. This is because many children will develop this problem in that hip later.

 

Outlook (Prognosis)

 

The outcome is most often good with treatment. In rare cases, the hip joint may wear away, despite prompt diagnosis and treatment.

 

Possible Complications

 

This disorder is linked to a greater risk of osteoarthritis later in life. Other potential but rare complications include reduced blood flow to the hip joint and wearing away of hip joint tissue.

 

When to Contact a Medical Professional

 

If your child has ongoing pain or other symptoms of this disorder, have the child lie down right away and stay still until you get medical help.

 

Prevention

 

Weight control for obese children may be helpful. Many cases are not preventable.

 

 

References

Sankar WN, Horn BD, Wells L, Dormans JP. The hip. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics . 20th ed. Philadelphia, PA: Elsevier; 2016:chap 678.

Sawyer JR, Spence DD. Fractures and dislocations in children. In: Azar FM, Canale ST, Beaty JH, eds. Campbell's Operative Orthopaedics . 13th ed. Philadelphia, PA: Elsevier; 2017:chap 36.

 

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          Review Date: 12/9/2016

          Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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