What is slipped capital femoral epiphysis?

Here, Mr Gregory Firth, a leading paediatric orthopaedic surgeon, talks to us about slipped capital femoral epiphysis.

What is slipped capital femoral epiphysis, and what are the symptoms?

Slipped capital femoral epiphysis usually occurs in teenagers, where they develop a fracture through the growth plate of the proximal femur in the hip. They often present with hip or knee pain.

This can happen very acutely, but also slowly with time. It can, for this reason, be sometimes missed. There are treatment options available and once we get the right imaging and diagnosis, there are a variety of treatment options available.

How is it diagnosed?

Slipped capital femoral epiphysis is usually diagnosed via X-Ray, but sometimes we need to do MRI or CT scans if there are other things going on.

What treatment options are available for patients with slipped capital femoral epiphysis?

The most common treatment option involves a single surgical screw being placed across the slip to stabilise the femoral head. This is done under general anaesthetic. In some cases, another surgical procedure may be required.

What are the associated long-term complications?

There are a couple of things that can happen. They can develop avascular necrosis, where patients cannot stand comfortably. The blood supply to the femur is damaged in this case. In other cases, hip joint damage can occur, which can lead to arthritis of the hip.

In addition, if a patient has a very severe femoral slip, an osteotomy can be performed to correct the biomechanics of the hip joint. We need to assess these things on a case-by-case basis in order to decide on the most effective treatment option for the patient.

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