Kids Health Info

Slipped Upper Femoral Epiphysis SUFE

  • A 'Slipped Upper Femoral Epiphysis' (also called a 'SUFE') is a condition involving the hip joint.  The hip joint works as a ball and socket.  With a SUFE, the growth plate (called the epiphyseal plate) at the top of the thigh bone is weak and the ball (head of the femur) slips downward and backward. The exact cause of this condition is not known, but there may be a link between increased weight and puberty hormones.  A 'SUFE' is not usually associated with an injury.  The symptoms often develop slowly - over several months - and may seem like a pulled muscle in the hip, thigh or knee.  It is important to get an early diagnosis and treatment before the slip gets worse and children may need to have the unaffected side treated as well to prevent future slipping.

    Signs and symptoms

    • Groin, hip, thigh or knee pain. Some people only have knee pain, even though the condition affects the hip
    • Limp
    • Limited movement of the hip joint
    • There may be slight shortening of the affected leg.

    Diagnosis

    Diagnosis is usually made by physical examination of hip movement and an x-ray.  Sometimes a CT scan or bone scan is also needed for diagnosis. 

    Treatment

    Treatment depends on how severe the slip is.  Most children need an operation to put metal screws into the head of the femur to help keep their hip stable.  An x-ray is taken after surgery to make sure the screws are in the right place.  

    Your child will need to stay at least 1-2 nights in hospital and will be able to go home once they feel comfortable and safe using crutches or a wheelchair.  They won't be able to stand with all their weight on the affected side for about 6 weeks and so will need to keep using crutches or a wheelchair. You'll be able to get these from the hospital and staff will teach you and your child how to use them safely.

    The screws can be taken out once the growth plate has closed.

    Care at home

    • Wound care
      Your child will have a small wound on the side of their leg, with a waterproof dressing over it.  Nurses will give you instructions what to do with the dressing.  Make sure you ask if you're not sure.
    • Pain relief
      Most children need some regular pain relief for the first few days after surgery, such as Panadol and/or codeine.  Ask the nurses, doctors or pharmacist about what to give and how often.

    Follow-up 

    • You may be asked to come back to the hospital 1-2 weeks after going home for a wound check and an x-ray.
    • Some children can come back after 6 weeks instead - doctors will discuss the follow-up plan with you before you leave the hospital.
    • If your child has any signs of wound infection (see Orthopaedic wound care) please contact your local doctor, the RCH Orthopaedic Outpatient Department or go to your nearest Emergency Department.

    Key points to remember

    • A SUFE can happen spontaneously and is not usually associated with an injury.
    • Often the onset of symptoms may be slow (over several months), gradually getting worse.
    • The symptoms seem like a pulled muscle or strain of the hip, thigh or knee.
    • Children may need to have the unaffected side treated as well to prevent future slipping.

    More information

    Individual information


     

    Developed by RCH Orthopaedics.  First published 2004. Updated May 2010.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.