Slipped capital femoral epiphysis (SCFE or skiffy, slipped upper femoral epiphysis, SUFE or souffy, coxa vara adolescentium) is a medical term referring to a fracture through the growth plate (physis), which results in slippage of the overlying end of the femur (metaphysis).

Running, and other strenuous activity on legs, will also cause the hips to abnormally move due to the condition and can potentially worsen the pain.

[6] 17–47 percent of acute cases of SCFE lead to the death of bone tissue (osteonecrosis) effects.

[2] In general, SCFE is caused by increased force applied across the epiphysis, or a decrease in the resistance within the physis to shearing.

Stress around the hip causes a shear force to be applied at the growth plate, with metaphysis anteriorly translating and externally rotating, while epiphysis remains within acetabulum.

Obesity is the most important predisposing factor in the development of SCFE (working by increasing axial load).

The physis being more vertical and weak, perichondrial ring being thin and unlocking of interlocking mamillary processes - in adolescence - contributes to high incidence.

Manipulation of the fracture (as in an attempted reduction, especially a forceful one) frequently results in osteonecrosis and the acute loss of articular cartilage (chondrolysis) because of the tenuous nature of the blood supply.

[11] The appearance of the head of the femur in relation to the shaft likens that of a "melting ice cream cone", visible with Klein's line.

In severe cases, after enough rest the patient may require physical therapy to regain strength and movement back to the leg.

A SCFE is an orthopaedic emergency, as further slippage may result in occlusion of the blood supply and avascular necrosis (risk of 25 percent).

[citation needed] The risk of reducing this fracture includes the disruption of the blood supply to the bone.

A small incision is made in the outer side of the upper thigh and metal pins are placed through the femoral neck and into the head of the femur.

[2] SCFEs are most common in adolescents 11–15 years of age,[6] and affects boys more frequently than girls (male 2:1 female).

[14] Other risk factors include: family history, endocrine disorders, radiation / chemotherapy, and mild trauma.