A new approach to treating a common hip disorder is showing positive results for orthopaedic surgeons at IWK Health. The use of a free-gliding screw system to treat slipped capital femoral epiphysis (SCFE) promises to correct the condition without inhibiting the patient’s natural growth, allowing for some reshaping of the deformity created by the SCFE.
SCFE is a hip condition that occurs in teens and pre-teens during periods of rapid growth, shortly after the onset of puberty. In SCFE, the head or ball part of the femur (thighbone), slips backwards off the neck of the bone at the growth plate, like ice cream slipping off a cone. Treatment for SCFE involves surgery to stop the head of the femur from slipping any further by placing a screw through the neck (or cone) and into the ball (or ice cream). In the past these screws have usually resulted in growth stopping but the new device allows for ongoing growth.
“The most exciting part of this research is that we have shown that normal growth can continue to occur in hips that are treated to avoid a SCFE and in hips where a SCFE has taken place,” says paediatric orthopaedic surgeon Dr. Karl Logan. “And that some reshaping of the deformity created by the SCFE can occur, which we hope will reduce symptoms afterwards for patients with this condition.”
Sometimes SCFE occurs suddenly after a minor fall or trauma. More often, however, the condition develops gradually over several weeks or months, with no previous injury. In boys, this most commonly occurs between the ages of 12 and 14; in girls, between the ages of ten and 12. Most often children will complain of pain in their hip or knee and have a limp on the same side which makes the leg on that side look shorter when they walk. An X-ray is used to make the diagnosis. Approximately 20 children are treated at the IWK with this condition every year.
This new procedure is a truly Canadian innovation which should improve the treatment of SCFE around the world,” says Dr. Ron El-Hawary, chief of orthopaedics at IWK Health. “The device itself was developed by our colleagues in Montreal, while the largest clinical research study has been performed here at IWK Health and has involved children from all over the Maritime Provinces.”