Slipped Capital Femoral Epiphysis

Slipped Capital Femoral Epiphysis:

Risk factors:

-Insidious onset
-Adolescent disease ages 10-17 y/o
-More common in obese males
-20% chance of contralateral leg developing pathology within 18 months
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Presentation:


Begins with anterior thigh pain, usually with no mechanism of injury.  The physis (growth plate) fractures at the head of the femur.  The head of the femur remains in the acetabulum while the end of femur (metaphysis) moves anterior, resulting in mal-alignment or slipping of the femur.


Patient presents with waddling gait pattern, with the hip abducted and flexed with external rotation.  Patient will present with shorter limb on the affected side.  Patient will resent with adductor spasm and atrophy of the quadricep.   Limited hip ROM and noted with increase pain.  Pain at supra-patella and anterior thigh pain.


If suspected, patient should be non-weight bearing immediately.  Diagnosed through x-rays.  If positive hip is pinned through the Southwick Osteotomy procedure. 

Classification:


Slipped Capital Femoral Epiphysis:
-Type I: less then 33% displacement
-Type II: Between 33 and 50% displacement
-Type III: Greater then 50% displacement