Bone, Joint and Muscle Conditions

Slipped Capital Femoral Epiphysis (SCFE)

What Is Slipped Capital Femoral Epiphysis?

Slipped SCFE. Courtesy of

Slipped capital femoral epiphysis.

Slipped capital femoral epiphysis (SCFE; pronounced "skiffy") is when the top of the thighbone slips out of place. To understand SCFE it helps to know a little about what the hip joint looks like.

The top part of the thighbone is shaped like a ball (femoral head). It fits into the hip socket. The ball is connected to the straight part of the thighbone by the growth plate. The growth plate is an area of tissue that, in children, is still developing.

In SCFE, the top or cap of the ball slips off the femoral head through the growth plate. Think of the ball as being like a scoop of ice cream that falls off its "cone," the thighbone.

Almost all children with the condition have surgery. Most do well. But some develop problems later due to the condition.

One foot might point outward more than the other, or one leg may be slightly longer than the other. Blood may stop flowing to the top part of the thighbone. Children's hips may be stiff, and they may be more likely to develop arthritis at an early age.

Other children with more severe slips have a greater risk that the fracture will not heal.

Slipped Capital Femoral Epiphysis in Children

Both boys and girls get SCFE. They are almost always approaching their teenage years or just into them (adolescents) when the problem occurs. Several other factors can contribute to a child's chances of having the problem. SCFE is more likely to develop in:

  • Overweight children
  • Children with a family history of SCFE
  • Children who have diseases of the endocrine system, which produces hormones. Diabetes and Cushing syndrome are examples of endocrine system diseases.
  • Children with kidney failure, thyroid problems or growth hormone abnormalities

Slipped Capital Femoral Epiphysis at Seattle Children's

Our orthopedic surgeons have extensive experience in identifying, treating and managing SCFE. Our doctors are experts in stabilizing the bone so the ball does not slip any more. We are also leaders in more complicated operations to reposition bones.