Slipped upper femoral epiphysis
ICD-10 M93.0 · ICD-11 FB82.2

Treatment of Stable Slipped Capital Femoral Epiphysis in Children Aged 8–15 Years

Slipped capital femoral epiphysis (SCFE) is one of the most commonly missed diagnoses in children, typically occurring between ages 8 and 15. When the affected child can still walk — with or without crutch support — the slip is classified as stable, representing the large majority of all presentations.

Clinical scenario A child aged 8–15 with confirmed stable SCFE who retains the ability to ambulate, with or without crutches. Stability is determined by the integrity of the physis and directly governs the management pathway for this age group.

Management approach

Immediate management centres on eliminating weight-bearing through mechanical support. Definitive care involves a surgical stabilisation procedure targeting the proximal femoral epiphysis. The complete step-by-step regimen, including referral urgency and technical specifics, is available in the full protocol.

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References

SCFE usually occurs in those eight to 15 years of age and is one of the most commonly missed diagnoses in children.

Classification of SCFE is based on the stability of the physis.

If the patient is able to ambulate with or without crutches, the SCFE is considered stable.

Stable SCFE accounts for about 90% of all slips.

Once the diagnosis of SCFE is made, the patient should be placed on non-weight-bearing crutches or in a wheelchair and urgently referred to an orthopedic surgeon familiar with the treatment of SCFE.

The standard treatment of stable SCFE is in situ fixation with a single screw.

Case series and animal studies have shown this to be a simple technique with low rates of recurrence and complications.

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