Slipped Capital Femoral

Epiphysis
))SCFE

.Leonel Copeliovitch M.D

”Assaf Harofe Medical Center“
 SCFE
 Antero-lateral displacement of the
femoral neck from the epiphysis
 Occurs during adolescent growth
spurt
 Bilateral in 10 to 80% of cases
 More common on the left than the
right
 Affects 1 – 3 per 100,000 people
 SCFE
 Males: 60%, Females:40% of the
cases
 Obese child)2/3) or rapidly growing
tall adolescent)1/3)
 In 5% , parents with SCFE
 SCFE- Risk Factors
 Physeal height
 Planar physis
 Load
 Abnormal physeal inclination
 Deficient physeal components
SCFE- disorders associated
 Endocrine :cryptorchidism,
hypothyroidism, adiposogenital
syndrome, acromegaly, growth
hormone therapy
 Genetic: Kleinfelter, Down, Marfan
 Metabolic: Rickets, renal
osteodystrophy
 SCFE- Pathology
 Slip occur between proliferative
and hypertrophic zones
 Physeal fracture occurs between
hypertrophic and calcification
zones
 SCFE- Clinic
 Stable, unstable
 Limp- Trendelenburg
 Limitations: abduction, internal
rotation and flexion
 Pain: groin, thigh or knee
 Limb shortening: 1 – 2 cm
 SCFE- Imaging
 X ray: AP, FROG
 Klein’s line, Capener’s sign
 Ultra sound
 Bone scan
 SCFE- classification
 Acute
 Chronic
 Acute on chronic
 SCFE- grading
 Till 30%
 30% to 60%
 Over 60%
 SCFE- treatment
 Internal fixation in situ
 Manipulation and internal fixation
 Osteotomies: Dunn, Southwick
 SCFE- complications
 Avascular necrosis )AVN)
 Chondrolysis
 Residual deformity
 Osteoarthritis