Slipped Capital Femoral Epiphysis | Treatments

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Contact the Child and Adult Hip Preservation Program

  • 617-355-6021
  • International: +1-617-355-5209
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Boston Children's Hospital hip sub-specialists provide comprehensive treatment—including evaluation, diagnosis, consultation and follow-up care. How we’ll treat your child’s SCFE depends on the complexity and severity of his condition—as well as his age, overall health, medical history and the expectations for the course of his condition as he grows.

The goals of SCFE treatment

The goals of treatment are to prevent the femoral head from further slippage and to avoid complications and eliminate hip impingement, which is the usual cause of arthritis in those SCFE hips that have later problems

In severe cases, surgery also aims to eliminate the deformities that cause hip impingement, which is the usual cause of arthritis in SCFE hips that have later problems.

What are the options for surgical treatment for SCFE?

Limited open surgery

This procedure uses steel screws and pins (internal fixation) to hold the femoral head onto the femur to stabilize it prevent it from slipping further; this is the standard of care for SCFE.
 
More complex surgical procedures for severe cases
•   can involve cutting and realigning the upper end of the femur (osteotomy) or reshaping the bone
    (osteochondroplasty)
•   carry some risk of damage to vessels supplying blood to the bone and to the health of the bone itself (avascular
    necrosis, or bone death 

My child’s SCFE is mild. Does he still need treatment?

If a child who has a mild case of SCFE remains relatively pain-free, parents may sometimes be tempted to leave their child’s diagnosed condition untreated. First, untreated slips almost always worsen with time—and unpredictably, the ball may completely slip off. But even if the child grows to adolescence without developing serious pain or a noticeable limp, it’s inevitable that his untreated hip will wear out and become arthritic in adulthood. Parents need to understand that sometimes SCFE treatment in childhood is prophylactic (preventive)—to prevent osteoarthritis or other hip problems later on. 

Care before and after surgery

Before your child’s procedure, he must avoid putting weight on the hip until after treatment. He may be instructed to use crutches or a wheelchair until his surgery.

After surgery, your child will need to limit his weight-bearing by using crutches or a walker for about six to eight weeks. Physical therapy following surgery helps your child strengthen his hip and leg muscles.

Specialist care throughout your child’s growth period

Success rates are high for SCFE treatment at Boston Children’s. Even so, any child who’s been treated for SCFE must still be followed periodically by his orthopedist until his skeletal growth is complete. Your doctor will monitor your child’s repaired hip, since it needs to grow normally through the whole growth period in order to be durable for a lifetime.

The majority of surgical treatments for SCFE at Boston Children’s occur without major complications. But later in life, hip problems can recur, even after successful treatment in childhood. The more severe the case, the greater the chance for limited hip motion, different leg lengths and further hip problems in the future. At Boston Children’s we follow SCFE patients throughout their lives.

Long-term outlook

Treating your child’s hip as soon as symptoms develop greatly increases the likelihood of a successful outcome. The majority of children treated for SCFE at Boston Children’s have treatments that enable them walk, play, grow and live active lives.

However, since a significant percentage of children with SCFE in one hip will eventually develop the condition in the other hip, your child should continue to be followed by his orthopedist at least until he’s fully grown. Also, the more severe the case, the greater the chance for limited hip motion, different leg lengths and further hip problems in the future.

Coping and support

We at Boston Children’s understand that a hospital visit can be difficult. So, we offer many amenities to make your child’s—and your own—hospital experience as pleasant as possible. Visit the Center for Families for all you need to know about:

•   getting to Boston Children’s
•   accommodations
•   navigating the hospital experience
•   resources that are available for your family

In particular, we understand that you may have a lot of questions when your child is diagnosed with SCFE. Will my child need surgery? How long will his recovery take? Will it affect my child long term? What should we do at home? Boston Children’s can help you connect with extensive resources to help you and your family through this stressful time, including:

•   patient education: From doctor’s appointments to treatment to follow-up, our nurses and physical therapists will be
    on hand to walk you through your child’s diagnosis, surgery and recovery. And once your child is home, we’ll help you
    coordinate and continue the care and support he received at Boston Children’s. 
•   parent-to-parent: Want to talk with someone whose child has been treated for slipped capital femoral epiphysis?
    Our Hip Unit can often put you in touch with other families who’ve been through the same experience that you and
    your child are facing.
•   faith-based support: If you’re in need of spiritual support, we’ll connect you with the Boston Children’s chaplaincy.
    Our program includes nearly a dozen clergy—representing Protestant, Jewish, Muslim, Catholic and other faith
    traditions—who will listen to you, pray with you and help you observe your own faith practices during your hospital
    experience.
•   social work: Our social workers and mental health clinicians have helped many other families in your situation. We
    can offer counseling and assistance with issues such as coping with your child’s diagnosis, stresses relating to coping
    with illness and dealing with financial issues.

We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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