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In Situ Fixation of Slipped Capital Femoral Epiphysis
What you need to know about in situ fixation of slipped capital femoral epiphysis (SCFE):
In situ fixation is surgery to fix your child's SCFE. A screw or wires will be used to hold the epiphysis (head) of the femur (thighbone) in place.
How to help your child prepare for in situ fixation:
Your child's healthcare provider will talk to you about how your child should prepare for surgery. The provider may tell your child not to eat or drink anything after midnight on the day of his or her surgery. He or she will tell you what medicines your child can take or not take on the day of surgery.
What will happen during in situ fixation:
Your child will be given general anesthesia to keep him or her asleep and free from pain during surgery. The surgeon will make a small incision on your child's hip. He or she will insert a guidewire through the incision and move it toward your child's femur. The surgeon will use fluoroscopy (a type of x-ray) to help him or her place the guidewire in the right place. A hole will be drilled into the head of his or her femur. A screw will be inserted over the guidewire. The screw will then be placed into the bone to keep the head of the femur in place. The incision will be closed with stitches and covered with a bandage.
What will happen after in situ fixation:
Your child will not be able to place weight on the side of his or her body where surgery was done for 4 to 6 weeks. He or she will need to use crutches, or a wheelchair if surgery is done on both hips.
Risks of in situ fixation:
Your child's bone may fracture (break) during surgery. The head of your child's femur may slip even more off of the bone during surgery. Lack of blood flow to your child's bone may lead to death of bone tissue. This may cause his or her bone to break down. The screw or wires may go into the hip joint space and cause cartilage to wear down. This can cause pain and decreased movement in his or her leg.
Call your child's healthcare provider if:
- Your child has severe pain, even after he or she takes medicine.
- Your child has a fever or chills.
- Your child's incision wound is red, warm, or draining fluid.
- You have questions or concerns about your child's condition or care.
Your child may need any of the following:
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If your child takes blood thinner medicine, always ask if NSAIDs are safe for him or her. Always read the medicine label and follow directions. Do not give these medicines to children under 6 months of age without direction from your child's healthcare provider.
- Acetaminophen decreases pain and fever. It is available without a doctor's order. Ask how much to give your child and how often to give it. Follow directions. Read the labels of all other medicines your child uses to see if they also contain acetaminophen, or ask your child's doctor or pharmacist. Acetaminophen can cause liver damage if not taken correctly.
- Prescription pain medicine may be given. Ask your child's healthcare provider how to give this medicine safely. Some prescription pain medicines contain acetaminophen. Do not give your child other medicines that contain acetaminophen without talking to his or her provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask how to prevent or treat constipation.
- Do not give aspirin to children under 18 years of age. Your child could develop Reye syndrome if he takes aspirin. Reye syndrome can cause life-threatening brain and liver damage. Check your child's medicine labels for aspirin, salicylates, or oil of wintergreen.
- Give your child's medicine as directed. Contact your child's healthcare provider if you think the medicine is not working as expected. Tell him or her if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
Care for your child:
- Ask about activity. Ask when your child can return to his or her daily activities, such as school and sports.
- Use support devices as directed. Your child will need to use crutches for 4 to 6 weeks after surgery. It is important to use crutches correctly. Ask your child's healthcare provider for more information about how to use crutches, if needed. Your child may need to use a wheelchair if surgery was done on both hips.
- Take your child to physical therapy as directed. A physical therapist teaches your child exercises to help improve movement and strength, and to decrease pain.
Follow up with your child's healthcare provider as directed:
Your child may need to return for x-rays every 3 to 6 months until his or her bones mature. His or her other leg may also need to be checked for SFCE. Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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