Thursday, March 28, 2024
HomeOrthopedic SurgerySlipped Capital Femoral Epiphysis Surgery

Slipped Capital Femoral Epiphysis Surgery

Background

Slipped capital femoral epiphysis (SCFE) was first described by Ernst Müller, who called it Schenkelhalsverbiegungen im Jungesalter (“bending of the femoral neck in adolescence”). The term slipped capital femoral epiphysis is actually a misnomer, because the epiphysis is held in the acetabulum by the ligamentum teres; thus, the metaphysis actually moves proximally and anteriorly while the epiphysis remains in the acetabulum.
(See the image below.)

Bilateral slipped capital femoral epiphysis. One s

Bilateral slipped capital femoral epiphysis. One side shows evidence of remodeling of the neck and an anterior bone bump that restricts flexion. The other side demonstrates an acute slip as seen by the absence of any evidence of remodeling.

View Media Gallery

In most patients, SCFE appears radiographically as a varus relation between the head and the neck.
Occasionally, the slip appears to be in a valgus position, with the epiphysis displaced superiorly in relation to the neck.
In the vast majority of cases, the etiology is unknown, though atypical slips may be associated with a known endocrine disorder, with renal failure osteodystrophy, or with previous radiation therapy.

SCFE is not life-threatening. However, untreated and complicated SCFE can lead to deformity and early osteoarthrosis of the hip and thus can cause considerable morbidity. Factors that increase morbidity include avascular necrosis (AVN) of the hip and chondrolysis.
Both of these may result in damage severe enough to warrant a salvage procedure, in the form of an arthrodesis or a total hip arthroplasty. Prompt diagnosis is critical to prevent further deformity and AVN. The diagnosis is often subtle, and symptoms (eg, groin or knee pain) can be misleading.

RELATED ARTICLES
- Advertisment -

Most Popular