Slipped Upper Femoral Epiphysis

What is a Slipped Upper femoral Epiphysis?

A Slipped Upper Femoral Epiphysis (SUFE) is a condition that affects the hip joint in children.  Children have growth plates (also called epiphyseal plates) that allow bones to lengthen. A SUFE involves a type of fracture through the growth plate causing the femoral head (the very top of the thigh bone) to slip out of position.

Children who have a SUFE often feel like they have pulled a muscle in their hip, thigh or knee. 

They will normally present with symptoms including:

  • Pain – this can be felt in the groin, thigh, hip and/or knee (Some children may only experience pain in their knee)
  • A limp
  • Resting their leg in an unusual posture 
  • Reduced hip movement 
  • A slight apparent shortening of their affected leg

Generally, these symptoms will develop gradually over several months. However, they can also present very suddenly.

SUFE is also sometime times referred to as Slipped Capital Femoral Epiphysis (SCFE)

Who gets it?

SUFE affects boys more than girls (2:1) and occurs in 1 per 10,000 children. It is the most common hip disorder affecting adolescent children, occurring on average in boys from 11-13 years old and girls from 12-14 years old.

The exact cause of SUFE is unknown, however it is linked with puberty and commonly occurs while children are experiencing rapid growth. It is also more likely to occur in children with a raised body mass index.

What is the treatment?

If you think your child has signs of a SUFE you should see your GP for an initial assessment.

If a child is suspected of having a SUFE, they will need to go to the emergency department at the hospital. The child should not put any weight through their leg and will need to be carried or use a wheelchair while they are awaiting further assessment.

All children with a SUFE will require surgery. The exact surgery will depend on how far the head of the femur has slipped. The surgery will usually involve metal screws being put through the head of the femur to hold it in place and preventing it from slipping further. X-rays will be taken to check the femoral head position following surgery. Some children will require surgery on the unaffected leg. This is because there is a high chance of a SUFE occurring on the unaffected side in the future. 

How long will my child need to stay in hospital?

After surgery, most children will stay one to two nights in hospital. They will be able to go home once they can safely use crutches or a wheelchair. The child will not be able to put all their weight through their leg for six weeks and will need to continue to use crutches or a wheelchair during this time.

When can my child return to sport?

Your orthopaedic surgeon will advise when it is possible to return to sport. Children will not be able to participate in contact sports until their hip has stopped growing and the screw has been removed.  During this time it is important for your child to stay active and participate in joint friendly exercises like swimming and bike riding.

What tests are required?

A physical examination as well as an X-ray will be required. In some cases an MRI may also be indicated.

What follow up is required?

Children require close monitoring by an orthopaedic surgeon after their surgery. These appointments are important and necessary to check that the hip joint continues to grow and develop appropriately. Further x-rays may be required for these appointments.