Slipped Capital Femoral Epiphysis Medication

  • Author: Kevin D Walter, MD, FAAP; Chief Editor: Craig C Young, MD   more...
 
Updated: Aug 11, 2011
 

Medication Summary

No medical therapy is available for the treatment of slipped capital femoral epiphysis (SCFE) except symptomatic pain relief. Medications may include acetaminophen, nonsteroidal anti-inflammatory drugs, or narcotics, depending on the physician's preference.

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Analgesics/Antipyretics

Class Summary

Pain control is essential to quality patient care. Analgesics ensure patient comfort and have sedating properties, which are beneficial for patients who have sustained trauma or who have sustained injuries.

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Acetaminophen (Tylenol, Feverall, Tempra)

 

DOC for pain in patients with documented hypersensitivity to aspirin or NSAIDs, with upper GI disease, or who are taking oral anticoagulants.

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Hydrocodone and acetaminophen (Vicodin, Lorcet, Lortab)

 

Drug combination for moderate to severe pain.

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Codeine/acetaminophen (Tylenol With Codeine #2, #3, #4)

 

Indicated for mild to moderate pain. Opioid and analgesic.

Acetaminophen and codeine content of Tylenol products is as follows:

Tylenol #2: 300 mg acetaminophen/15 mg codeine

Tylenol #3: 300 mg acetaminophen/30 mg codeine

Tylenol #4: 300 mg acetaminophen/60 mg codeine

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Nonsteroidal Anti-inflammatory Drugs (NSAIDs)

Class Summary

NSAIDs have analgesic, anti-inflammatory, and antipyretic activities, which make these ideal agents for treating ankle injuries. The mechanism of action of NSAIDs is not known, but they may inhibit cyclooxygenase activity and prostaglandin synthesis. Other mechanisms may exist as well, such as inhibition of leukotriene synthesis, lysosomal enzyme release, lipoxygenase activity, neutrophil aggregation and various cell membrane functions.

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Ibuprofen (Motrin, Advil)

 

DOC for mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing prostaglandin synthesis.

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Ketoprofen (Orudis, Actron, Oruvail)

 

Indicated for mild to moderate pain and inflammation.

Small initial doses are indicated in small and elderly patients and in those with renal or liver disease.

Doses >75 mg do not increase the therapeutic effects. Administer high doses with caution, and closely observe the patient for the response.

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Naproxen (Naprelan, Anaprox, Naprosyn)

 

Indicated for mild to moderate pain; inhibits inflammatory reactions and pain by decreasing the activity of cyclooxygenase, which results in a decrease of prostaglandin synthesis.

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Contributor Information and Disclosures
Author

Kevin D Walter, MD, FAAP  Assistant Professor, Department of Pediatric Orthopaedics and Department of Pediatrics, Medical College of Wisconsin; Member of Children's Specialty Group of Children's Hospital of Wisconsin; Program Director, Children's Hospital of Wisconsin Pediatric and Adolescent Primary Care Sports Medicine

Kevin D Walter, MD, FAAP is a member of the following medical societies: American Academy of Pediatrics and American Medical Society for Sports Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

David Y Lin, MD  Fellow, Department of Orthopedic Surgery, Section of Pediatrics, University of Tennessee Campbell Clinic

David Y Lin, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons

Disclosure: Nothing to disclose.

Evan Schwartz, MD  Director of Orthopedic Surgery, New York Medical College; Assistant Professor, St John's Queens Hospital, Department of Surgery, Albert Einstein School of Medicine

Evan Schwartz, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons and American Orthopaedic Society for Sports Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Anthony J Saglimbeni, MD  President, South Bay Sports and Preventive Medicine Associates; Private Practice; Team Internist, San Francisco Giants; Team Internist, West Valley College; Team Physician, Bellarmine College Prep; Team Physician, Presentation High School; Team Physician, Santa Clara University; Consultant, University of San Francisco, Academy of Art University, Skyline College, Foothill College, De Anza College

Anthony J Saglimbeni, MD, is a member of the following medical societies: California Medical Association and Santa Clara County Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Jon B Whitehurst, MD  Clinical Instructor of Surgery, University of Illinois College of Medicine; Partner, Rockford Orthopedic Associates; Orthopedic Chairman, Rockford Memorial Hospital

Jon B Whitehurst, MD is a member of the following medical societies: American Academy of Orthopaedic Surgeons, American Orthopaedic Society for Sports Medicine, and Arthroscopy Association of North America

Disclosure: Nothing to disclose.

Chief Editor

Craig C Young, MD  Professor, Departments of Orthopedic Surgery and Community and Family Medicine, Medical Director of Sports Medicine, Director of Primary Care Sports Medicine Fellowship, Medical College of Wisconsin

Craig C Young, MD is a member of the following medical societies: American Academy of Family Physicians, American College of Sports Medicine, American Medical Society for Sports Medicine, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author, Henry Marano, MD, to the development and writing of this article.

References

  1. Kehl DK. Slipped capital femoral epiphysis. In: Lovell WW, Winter RB, Morrissy RT, Weinstein SL, eds. Lovell & Winter's Pediatric Orthopaedics. 4th ed. Philadelphia, Pa: Lippincott, Williams & Wilkins; 1996.

  2. Katz DA. Slipped capital femoral epiphysis: the importance of early diagnosis. Pediatr Ann. Feb 2006;35(2):102-11. [Medline].

  3. Loder RT. Controversies in slipped capital femoral epiphysis. Orthop Clin North Am. Apr 2006;37(2):211-21, vii. [Medline].

  4. Frick SL. Evaluation of the child who has hip pain. Orthop Clin North Am. Apr 2006;37(2):133-40, v. [Medline].

  5. Peterson MD, Weiner DS, Green NE, Terry CL. Acute slipped capital femoral epiphysis: the value and safety of urgent manipulative reduction. J Pediatr Orthop. Sep-Oct 1997;17(5):648-54. [Medline].

  6. Loder RT, Richards BS, Shapiro PS, Reznick LR, Aronson DD. Acute slipped capital femoral epiphysis: the importance of physeal stability. J Bone Joint Surg Am. Aug 1993;75(8):1134-40. [Medline]. [Full Text].

  7. Klein A, Joplin RJ, Reidy JA, Hanelin J. Roentgenographic features of slipped capital femoral epiphysis. Am J Roentgenol Radium Ther Nucl Med. Sep 1951;66(3):361-74. [Medline].

  8. Uglow MG, Clarke NM. The management of slipped capital femoral epiphysis. J Bone Joint Surg Br. Jul 2004;86(5):631-5. [Medline].

  9. Crawford AH. Slipped capital femoral epiphysis. J Bone Joint Surg Am. Oct 1988;70(9):1422-7. [Medline]. [Full Text].

  10. Stanitski CL. Acute slipped capital femoral epiphysis: treatment alternatives. J Am Acad Orthop Surg. Mar 1994;2(2):96-106. [Medline].

  11. Lehmann CL, Arons RR, Loder RT, Vitale MG. The epidemiology of slipped capital femoral epiphysis: an update. J Pediatr Orthop. May-Jun 2006;26(3):286-90. [Medline].

  12. Kelsey JL, Keggi KJ, Southwick WO. The incidence and distribution of slipped capital femoral epiphysis in Connecticut and Southwestern United States. J Bone Joint Surg Am. Sep 1970;52(6):1203-16. [Medline]. [Full Text].

  13. Azzopardi T, Sharma S, Bennet GC. Slipped capital femoral epiphysis in children aged less than 10 years. J Pediatr Orthop B. Jan 2010;19(1):13-8. [Medline].

  14. Riad J, Bajelidze G, Gabos PG. Bilateral slipped capital femoral epiphysis: predictive factors for contralateral slip. J Pediatr Orthop. Jun 2007;27(4):411-4. [Medline].

  15. Hagglund G, Hansson LI, Ordeberg G, Sandstrom S. Bilaterality in slipped upper femoral epiphysis. J Bone Joint Surg Br. Mar 1988;70(2):179-81. [Medline]. [Full Text].

  16. Benson EC, Miller M, Bosch P, Szalay EA. A new look at the incidence of slipped capital femoral epiphysis in new Mexico. J Pediatr Orthop. Jul-Aug 2008;28(5):529-33. [Medline].

  17. Zupanc O, Krizancic M, Daniel M, et al. Shear stress in epiphyseal growth plate is a risk factor for slipped capital femoral epiphysis. J Pediatr Orthop. Jun 2008;28(4):444-51. [Medline].

  18. Brenkel IJ, Dias JJ, Davies TG, Iqbal SJ, Gregg PJ. Hormone status in patients with slipped capital femoral epiphysis. J Bone Joint Surg Br. Jan 1989;71(1):33-8. [Medline]. [Full Text].

  19. Pritchett JW, Perdue KD. Mechanical factors in slipped capital femoral epiphysis. J Pediatr Orthop. Jul-Aug 1988;8(4):385-8. [Medline].

  20. Wells D, King JD, Roe TF, Kaufman FR. Review of slipped capital femoral epiphysis associated with endocrine disease. J Pediatr Orthop. Sep-Oct 1993;13(5):610-4. [Medline].

  21. Zubrow AB, Lane JM, Parks JS. Slipped capital femoral epiphysis occurring during treatment for hypothyroidism. J Bone Joint Surg Am. Mar 1978;60(2):256-8. [Medline]. [Full Text].

  22. Dwek JR. The hip: MR imaging of uniquely pediatric disorders. Magn Reson Imaging Clin N Am. Aug 2009;17(3):509-20, vi. [Medline].

  23. Tins B, Cassar-Pullicino V, McCall I. The role of pre-treatment MRI in established cases of slipped capital femoral epiphysis. Eur J Radiol. Apr 23 2008;epub ahead of print. [Medline].

  24. Aronson DD, Carlson WE. Slipped capital femoral epiphysis. A prospective study of fixation with a single screw. J Bone Joint Surg Am. Jul 1992;74(6):810-9. [Medline]. [Full Text].

  25. Ward WT, Stefko J, Wood KB, Stanitski CL. Fixation with a single screw for slipped capital femoral epiphysis. J Bone Joint Surg Am. Jul 1992;74(6):799-809. [Medline]. [Full Text].

  26. Kocher MS, Bishop JA, Hresko MT, et al. Prophylactic pinning of the contralateral hip after unilateral slipped capital femoral epiphysis. J Bone Joint Surg Am. Dec 2004;86-A(12):2658-65. [Medline]. [Full Text].

  27. Weiner DS, Weiner S, Melby A, Hoyt WA Jr. A 30-year experience with bone graft epiphysiodesis in the treatment of slipped capital femoral epiphysis. J Pediatr Orthop. Mar 1984;4(2):145-52. [Medline].

  28. Betz RR, Steel HH, Emper WD, Huss GK, Clancy M. Treatment of slipped capital femoral epiphysis. Spica-cast immobilization. J Bone Joint Surg Am. Apr 1990;72(4):587-600. [Medline]. [Full Text].

  29. Witbreuk MM, Bolkenbaas M, Mullender MG, Sierevelt IN, Besselaar PP. The results of downgrading moderate and severe slipped capital femoral epiphysis by an early Imhauser femur osteotomy. J Child Orthop. Sep 26 2009;[Medline]. [Full Text].

  30. Lawane M, Belouadah M, Lefort G. Severe slipped capital femoral epiphysis: The Dunn's operation. Orthop Traumatol Surg Res. Nov 18 2009;epub ahead of print. [Medline].

  31. Castaneda P, Macias C, Rocha A, Harfush A, Cassis N. Functional outcome of stable grade III slipped capital femoral epiphysis treated with in situ pinning. J Pediatr Orthop. Jul-Aug 2009;29(5):454-8. [Medline].

  32. Krahn TH, Canale ST, Beaty JH, Warner WC, LourenCo P. Long-term follow-up of patients with avascular necrosis after treatment of slipped capital femoral epiphysis. J Pediatr Orthop. Mar-Apr 1993;13(2):154-8. [Medline].

  33. Larson AN, Yu EM, Melton LJ 3rd, Peterson HA, Stans AA. Incidence of slipped capital femoral epiphysis: a population-based study. J Pediatr Orthop B. Jan 2010;19(1):9-12. [Medline].

 
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A Klein line is a line drawn along the superior border of the femoral neck that would normally pass through a portion of the femoral head. If not, slipped capital femoral epiphysis is diagnosed.
X-ray of a hip following operative percutaneous fixation of a slipped capital femoral epiphysis.
 
 
 
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