Slipped capital femoral epiphysis (SCFE)
Most common in ages 9 – 15. 25% bilateral. M>F. Characterised by disruption of structural integrity of the proximal epiphyseal plate of femur displacement of head relative to neck of femur potential for vascular disruption. Similar to Salter Harris type 1 fracture.
Rarely due to trauma
Most are obese. Present with limp and pain over anterior aspect of hip (may be acute or insidious) – gait is often antalgic and externally rotated; usually unable to bear weight on affected side. Joint is tender and internal rotation is restricted. May get referred pain to knee. On examination leg appears shorter, hip abduction and internal rotation is restricted.
Immediate non-weightbearing (bed rest if severe, otherwise wheelchair or crutches)
Surgical intervention is almost always needed (pinning and maybe osteotomy).
Early recognition and prompt surgical intervention is associated with better outcomes.
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