What should you know about unstable SCFE?

SCFE occurs when the upper end of the thigh bone shifts through the growth plate near the hip. In an unstable slip, pain and displacement make weight-bearing impossible, even with support. Pain may be felt in the hip, groin, thigh, or knee, so the knee can appear to be the problem. A limp may have preceded the sudden worsening; see the guide to [Limping](/symptoms/limping/).

This is an orthopedic emergency because movement can worsen the slip and affect the blood supply to the hip. Do not test walking or try to straighten the leg at home.

Keep the child or teenager still and avoid all weight on the affected leg. Arrange urgent evaluation at an emergency service with orthopedic expertise. Imaging helps show the position of the growth plate and guides treatment. The specialist may recommend surgical stabilization, commonly using fixation to hold the slip in place; learn more about [Fracture Fixation Surgery](/treatments/trauma-and-fracture-care/fracture-fixation-surgery/).

Bring a list of medicines and describe when walking became impossible. Do not give food or drink if emergency staff advise that an operation may be needed soon.

Seek emergency care immediately for inability to stand or walk, sudden severe hip or thigh pain, a leg held turned outward, or rapidly increasing pain after a period of limping. Call local emergency services if safe transport cannot be arranged. Keep the person seated or lying down until help arrives.

Ask whether the slip is stable or unstable, which hip imaging is needed, how the leg will be protected before surgery, and what changes should prompt an immediate return. Also ask when rehabilitation can begin and how the other hip will be monitored.