Slipped capital femoral epiphysis

Legs | Orthopaedics | Slipped capital femoral epiphysis (Disease)


Description

Slipped capital femoral epiphysis (SCFE) is an unusual disorder of the adolescent hip. It is not rare. For reasons that are not well understood, the ball at the upper end of the femur (thigh bone) slips off in a backward direction. This is due to weakness of the growth plate. Most often, it develops during periods of accelerated growth, shortly after the onset of puberty.

Causes and Risk factors

The cause of SCFE is unknown. It occurs two to three times more often in males than females. A large number of patients are overweight for their height. In most cases, slipping of the epiphysis is a slow and gradual process. However, it may occur suddenly and be associated with a minor fall or trauma. Symptomatic SCFE, treated early and well, allows for good long-term hip function.

Diagnosis and Treatment

The treatment is often surgical: it consists in fixing the femoral head to the cervix, usually through a helical motion. It must be done as quickly as possible, because complications can be serious disease: cartilage necrosis with painful muscle contractures. The upper epiphysis of the femur or the femoral head, caused by an abnormality of cartilage growth by conjugation. Increase lasts as long as femur, is separated from the epiphysis to the bone by a median cartilage very fragile area so that a disruptive disorder that can lead to increased displacement of the femoral head or outside the shrine. Coxa Vara - deformation of the upper extremity of the femur, characterized by a closing angle (angle between the femoral neck with the shaft). Long-term (several years, even after several decades), it gives, in general, the occurrence of arthritis early opportunity to be treated.

The only treatment is surgical coxa summer: he is to regain a normal angle between the femoral neck and shaft. Osteonecrosis can occur following trauma (femoral neck fracture that divide vessels that feed it, semilunar wrist fracture) or hyperpresions of the bone (osteonecrosis plunger underwater), in the course of disease (diabetes, sickle cell disease, alcoholism) or treatment with corticosteroids. Sometimes, especially in children, the disease is not found. ...