Slipped Capital Femoral Epiphysis

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Clinically Relevant Anatomy

 Slipped Capital Femoral Ephysis (SCFE) occurs in the adolescent population. It occurs when the femoral epiphysis slips posteriorly on the femoral neck at the physis. In actuality, the metaphysis of the femoral neck is displaced superiorly and anteriorly of the capital femoral epiphysis. ¹

Mechanism of Injury / Pathological Process

 There are several factors that can contribute to developing a SCFE. The most widely recognized factor is obesity. It is hypothesiszed that as weight increases shearing forces across the physis are also increased causing it to weaken.¹ Other  mechanical contributers to this condition are retroversion of the femur,and incresed physeal obliquity. Changes is hormone  levels ( spikes in testosterone) during growth spurts can having a weakening effect on the physis.There is some association with endocrine disorders, however this is not a prevelent finding. ^1,2

 There are several classification systems to determine the severity of a SCFE. One delinates the disorder into acute, acute-on-chronic, and chronic. Acute signifies the SCFE occured with trauma and results in immmediate pain and decreased hip ROM ( abduction and internal rotation). Acute-on chronic  decsribes a patient having symptoms for months and then has an increased slip due to trauma. Chronic is identified as the most common presentation, and the child has had symptoms for several months.²

The preferred classification system is stable/unstable which is based on the weightbearing ability of the child. A classifcation of stable is given to those who can bear weight with/without an assistive device on the affected leg. Those who cannot are deemed unstable.¹

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