Abstract
Purpose: The purpose of this report is to describe the clinical course of a patient with a slipped capital femoral epiphysis (SCFE) who was subsequently diagnosed with avascular necrosis of the femoral head. Case Description: The patient was a 15-year-old male seen by a physical therapist 2 months after in-situ fixation with 2 screws for a SCFE. One week after undergoing surgery, the patient experienced a considerable increase in left hip pain. Radiographs revealed inadequate fixation and a second surgical fixation was performed with 5 screws. On examination, the patient was ambulating weight bearing as tolerated with bilateral axillary crutches. Range of motion of the left hip was limited in all planes and weakness was noted for the left hip musculature. A rehabilitation program was initiated and over the course of the next 6 months, the patient made significant improvement in terms of function. However, over the course of the last week of the sixth month, the patient began to report an insidious onset of increasing left hip pain. The patient’s gait was now antalgic and range of motion of the left hip was decreased due to pain. Outcomes: The patient was immediately referred to his orthopedic surgeon. Radiographs revealed fragmentation and collapse of the left femoral head, which are findings consistent with avascular necrosis of the femoral head. In an effort to prevent progression, the surgical screws were removed, and the patient continued to be managed by a physical therapist. One year following screw removal, there was no further collapse of the femoral head and the patient’s pain was minimal, and he had essentially returned to full function. Discussion: It is important for clinicians to have an understanding of the clinical findings associated with avascular necrosis following a SCFE, as these findings provide important guidance for diagnostic imaging and specialist referral.
Recommended Citation
Boggs RG, Ross M, Justin Petrocy , Michael Tall . Avascular Necrosis of the Hip Following Surgical Repair of a Slipped Capital Femoral Epiphysis: A Case Report. The Internet Journal of Allied Health Sciences and Practice. 2024 Jun 26;22(3), Article 15.
