Slipped femoral epiphysis (FSEC) is a rare disease in children. The reason is not clearly known. It occurs as a result of the growth line at the head of the femoral ball slipping away from its proper position. This is due to weakness in the growth plate.
Diagnosis of this disease depends on careful disease history, physical examination, gait pattern and x-ray of the hip.
Risk Factors
The cause of FBEK is unknown. It is 3 times more common in men than in women. Most of the patients are overweight compared to their peers. In many cases, it develops slowly and chronically. However, in rare cases, it may develop suddenly after a minor fall or trauma.
Diagnosis
A full hip joint range of motion is not expected during the physical examination. There is usually a loss of hip internal rotation and flexion. There is often pain due to inflammation in the hip and the pain spreads towards the knee, or the patient may come to the doctor with only knee pain.
Treatment
The aim of treatment is surgery. To prevent slippage and stabilize the hip, it is necessary to fix the femoral head with a screw in the position closest to the growth plate. If the femoral head is not fixed, hip movements are restricted and calcification occurs at an early age. Treatment should be planned between 24 and 48.
The most important factor in the success of treatment is early diagnosis. In surgical planning, fixation or immobilization is done with femoral head screws.
Complications
There are many serious undesirable conditions associated with FSEK. The most common ones are avascular necrosis and chondrolysis.
Avascular necrosis occurs as a result of decreased blood flow to the femoral head. There are no identified or known risk factors. It occurs 6 months to 2 years after the surgery.
Chondrolysis occurs with the loss of joint cartilage. It is the major and feared complication of FBEK. It causes hip stiffness and permanent loss of joint motion. It rarely responds to aggressive physical therapy and medical treatment.
After the surgery, the patient does not bear any weight on the hip and uses crutches for a week to 1 month. The follow-up period lasts between 18 and 24 months. A control film should be taken every 3 months.
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