Current Opinions in Pathogenesis of Slipped Capital Femoral Epiphysis (SCFE) of Children

Introduction

Slipped capital femoral epiphysis (SCFE) is a disorder of puberty characterized by slipping (movement) of the femoral head off the femoral neck. It is one of the most puzzling disorders that concerns both pediatrics and orthopedics. In SCFE the femoral head ultimately migrates to a position of posterior–inferior displacement relative to the femoral neck. The displacement may be sudden (acute) and produce an unstable situation in which the femoral head is mobile on the femoral neck, or it may occur slowly over a period of time (chronic), and produce a stable head–neck relationship in which the head is anchored to the femoral neck, but in a displaced position. Also there is a third form of SCFE called acute on chronic that is a combination of the above two types of SCFE.

Abstract

Slipped capital femoral epiphysis (SCFE) is an adolescent disorder that is characterized by slipping of the femoral head off the femoral neck. It is classified into acute, chronic, and acute on chronic types. This study examines not only the epidemiology and classification, but also the etiology and pathogenesis of SCFE. Recent studies imply that obesity, trauma, shear stress in growth plate, and hormonal disturbances are some of the contributing factors to SCFE. More studies will reveal the pathophysiological mechanisms of this multifactorial disorder that concerns both pediatrics and orthopedics.

Keywords

slipped capital femoral epiphysis, pathogenesis, adolescence, hormones, obesity