Orthopaedic Consequences of Slipped Capital Femoral Epiphysis in Adults

Abstract

Slipping of the femoral head usually occurs at the beginning of puberty. With sexual hormone deficiency the growth plates remain open with the danger of a Slipped Capital Femoral Epiphysis (SCFE) beyond the normal age of growth. In several endocrine disorders such as hypothyroidism or growth hormone deficiency, and especially during supplemental therapy with hormones, SCFE can occur. SCFE can occur even if the hormonal replacement therapy has stopped. Since 1984 we have seen and treated 7 adult patients (6 male, 1 female) with SCFE. They were between 17 and 36 years old. Due to the lack of sexual hormones three patients had severe osteoporosis which caused difficulties in surgical treatment. From the orthopaedic point of view regular clinical and radiological check-ups are necessary in patients with open physes beyond the normal growth age - especially in patients with endocrine dysfunction and hormonal supplement therapy. These reviews have to be continued until the growth plates are closed be-cause SCFE occur even after hormonal replacement has been stopped for years. Prophylactic screwing of the opposite hip is also recommended in high risk patients.