The Mighty Lions ~ Slipped Capital Femoral Epiphysis

It was the Championship final: The Eagles v The Lions. Brooklyn was playing centre forward, his most preferred position. As a gush of excitement ran through his veins, he couldn’t help but feel slightly nervous. They had come so far into the tournament and he didn’t want to lose. He didn’t want to let his team down. Especially not to the Eagles.

‘Go Lions, Go Lions, Go, Go, Go Lions…’ chanted the cheerleaders as the team ran onto the pitch. As they huddled, the team captain Alex gave them a few motivational words before they got into position. The whistle blew. The match had begun. The ball was passed from player to player. Brooklyn now had the ball, dribbling it further along the pitch, whilst taking frequent glances at the goal. Suddenly, as he was about to kick the ball, one of the Eagles slide-tackled him. He fell to the ground, with a stabbing, sharp pain in his hip. It was only five minutes into the game.

Brooklyn clung onto the excruciating pain in his hip as sweat dripped from his distressed face. He wanted to play on. As he tried to move his leg, the incapacity to do so sparked a fire of anger inside him. He was furious at the Eagles for playing dirty. The medical team arrived and placed him on a stretcher bed. As they took him of the pitch, the Lion supporters hissed at the Eagles and then cheered as their player received a yellow card.

In the emergency room, a team of doctors came to see Brooklyn promptly. They examined his hip and leg, and as they tried to move the hip joint in particular, he screamed. Subsequently, they gave him some painkillers and took an X-ray scan of both hips. Brooklyn heard the half-time whistle. The score was 2-1 to the Eagles. He was speechless, upset and in pain.

Once the X-ray results arrived, one of the doctors went to speak to Brooklyn. ‘Don’t worry about the score Brooklyn, the Lions have it under control. Alex has moved some players around. I’m telling you… the Lions will win!!’

‘Hopefully,’ Brooklyn prayed. ‘Will I be okay?’ he asked.

‘Yes. Your results show that you have a slipped capital femoral epiphysis. In lay terms, this means the bone at your hip has slipped out of place. The hip joint is like a ball and socket. The ball is the upper end of the thighbone and this sits in a socket called the acetabulum. The acetabulum is part of the pelvic bone and it has many ligaments and muscles to help stabilise the hip joint. The epiphysis is the area at each end of the thighbone and as growth is not usually fully completed in boys aged between 18-20 years, the upper epiphysis can occasionally slip out of their normal position in relation to the rest of the thigh bone’, the doctor explained.

‘It normally affects rapidly growing, tall, thin adolescents or overweight teenage boys. However, in your situation, an increased force was placed on the upper part of your thighbone, pulling and twisting it out of place, causing the epiphysis to slip. In overweight boys, their body weight puts an extra strain on the upper femur resulting in a slipped capital femoral epiphysis’, continued the doctor. ‘It usually occurs over a long period of time, but can also occur suddenly after a fall or injury, which is what has happened in your case’.

‘Is the pain this bad for everyone?!’ exclaimed Brooklyn.

‘In chronic cases, patients may complain of pain for weeks or months, which can get worse as the slip progresses. Acute cases have sudden onset of severe symptoms, and occasionally, a minor injury can escalate a chronic slip. Patients are unable to put any weight on the affected leg. With acute cases, one leg may appear shorter than the other and the leg may be turned outwards. Usually, chronic cases come on gradually, either as gradual groin pain or lower thigh and knee pain, which may be a bit misleading. Pain will be made worse on activity and the leg may also appear shorter, with wasting thigh muscles,’ clarified the doctor. ‘It is very common though; 10 in 100,000 teenagers will get this condition and in 1 in 5 cases, both femurs are affected. Additionally, it is 3 times more likely to affected boys than girls. It may also occur in patients with known hormone disorders such as underactive thyroid and kidney failure, but this is quite rare’, he continued as Brooklyn felt more reassured.

‘Will I still be able to play football?’ asked Brooklyn.

‘Yes, of course. However, you will need plenty of rest and will not be able to play for some time. We will need to operate on your affected hip urgently and stabilise the slipped epiphysis with a pin or screw to hold it in place and prevent it from moving any more. Sometimes, we also suggest stabilising the unaffected hip at the same time, as it can affect both hips. However, in your case, we feel it will be sufficient to treat the affected side only’, clarified the doctor. ‘One of the complications of a slipped epiphysis is damaging the blood supply to the ball of the thighbone. This is called avascular necrosis, but as we will be treating you urgently, complications are less likely. After the surgery, we will give you painkillers and refer you to physiotherapy. You will have to use crutches until your injury has healed completely’.

‘Thank you so much doctor. I trust you,’ murmured Brooklyn, his face agonising with unbearable pain.

‘You’re in good hands, young Brooklyn. You’ll be back on the pitch in no time, do not worry’, comforted the doctor.

And with those last words, Brooklyn heard the crowd roar with cheers. The Lions had scored just as the final whistle blew. The Lion chant began again. The Lions had won the Championship.

‘Told you they’d be fine’, winked the doctor. ‘Now let’s sort out your hip shall we…’

Brooklyn was relieved and ecstatic. The mighty Lions had finally beaten the Eagles, and his hip would get better. For now, he needed to rest.

Shrinal Kotecha

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