What should you know about SCFE of the femur?

The femoral head is the rounded upper end of the thigh bone that sits in the hip socket. During growth, a plate of softer tissue separates the head from the neck of the femur. In SCFE, the head becomes less well aligned across that plate. The leg may turn outward, and pain can be felt in the hip, groin, thigh or even the knee. Some children develop a limp without describing hip pain. One hip or both hips can be involved, and symptoms may develop gradually or appear after a minor event.

Stop sports, running and jumping, and do not ask the child to test the leg by walking. Use crutches or a wheelchair only as directed, because the safest choice depends on the examination. An orthopaedic clinician usually checks movement and obtains hip imaging. Treatment commonly aims to hold the femoral head in position with a small fixation device while the growth plate heals; the other hip may also be assessed. Follow instructions about bathing, school, mobility and later physiotherapy.

Arrange urgent medical assessment for a new limp, hip or thigh pain, groin discomfort, or pain referred to the knee in a growing child. Seek emergency help when the child cannot bear weight, has severe or rapidly worsening pain, or the leg suddenly appears turned outward. Do not delay because there was no fall or because the pain is felt at the knee. Until assessed, keep weight off the affected leg.

Which hip is affected, and is the growth plate stable? What imaging is needed? Should both hips be checked? How long must weight-bearing be limited? What signs after treatment should prompt an immediate call? When can school, sports and physiotherapy resume?