Musculoskeletal Disorders: Hip- and Thigh-bones

The main problems with the hip and thighbones in young children include knock knees (where the thighbone turn in, causing the knees to touch), and bow legs and much rarer, Legg-Calvé-Perthes disease (loss of the blood supply to the neck of the thighbone).
In adolescents, limping and pain in the hip, or sometimes in the knee or thigh, may be caused by a slipped capital femoral epiphysis.

Slipped Capital Femoral Epiphysis

Description

Slipped capital femoral epiphysis ( SCFE ) is a surgical emergency. It is also the most common hip disorder among young teenagers. A child’s symptoms may come on suddenly, or they may build up over time. Often the first pain is in the knee or thigh. The sooner a child gets treatment, the better off he or she will be.

Symptoms and Signs

SCFE happens when the cartilage plate ( epiphysis ) at the top of your child’s thighbone ( femur ) slips out of place. In a growing child, the plate is what controls the way the top of the thighbone grows. It’s also a pivotal part of the hip’s ball and socket joint, so slippage of the epiphysis may severely deform your child. Problems may include: he or she can’t turn the hip inward; his or her foot turns outward; his or her leg is measurably shorter; he or she suffers too much pain to stand on it.

Children aged 10-18 are at risk for SCFE, particularly African-American boys, and all children who are overweight or athletic. More than one-third of the time, children with SCFE in one hip develop the same condition in the other hip.

Diagnosis and Treatment

It’s important to recognise SCFE early and get the treatment the child needs right away. Surgery is less complicated and the outcome is better the sooner you get it done. If you don’t treat SCFE, a child’s deformities will get worse, and arthritis may set in.

Surgery involves stabilising your child’s hip with pins to stop the SCFE from getting any worse. The pins help the growth plate fuse into place and become stable. Your doctor may also want to pin your child’s other hip to prevent it from developing the same problem.

The information in this page is presented in summarised form and has been taken from the following source(s):
1. American Academy of Orthopaedic Surgeons: http://orthoinfo.aaos.org/