scholarly journals Shape of growth plate of proximal femur in children and its significance in the aetiology of slipped capital femoral epiphysis

2012 ◽  
Vol 36 (12) ◽  
pp. 2513-2520 ◽  
Author(s):  
Grzegorz Kandzierski ◽  
Łukasz Matuszewski ◽  
Anna Wójcik
1991 ◽  
Vol 11 (5) ◽  
pp. 631-637 ◽  
Author(s):  
Lee S. Segal ◽  
Richard S. Davidson ◽  
William W. Robertson ◽  
Denis S. Drummond

1977 ◽  
Vol 59 (8) ◽  
pp. 1076-1081 ◽  
Author(s):  
MR Mickelson ◽  
I. V. Ponseti ◽  
RR Cooper ◽  
JA Maynard

Author(s):  
Nicola Ebert ◽  
Martin Rupprecht ◽  
Ralf Stuecker ◽  
Sandra Breyer ◽  
Norbert Stiel ◽  
...  

Abstract Background In recent years, the modified Dunn osteotomy has gained popularity to treat slipped capital femoral epiphysis (SCFE) with various complication rates. Most studies included patients with different severities. This study aimed to determine (1) the radiological and clinical outcome, (2) the health-related quality of life, and (3) the incidence of avascular necrosis of the femoral head (AVN) in patients with severe chronic or acute on chronic SCFE treated by the modified Dunn procedure. Methods Out of 150 patients with SCFE treated at our institution between 2001 and 2014, 15 patients (mean age 12.9 years (range 11.8–15)) were treated by the modified Dunn procedure. Eight SCFE were chronic and 7 acute on chronic. All slips were severe with a mean Southwick slip angle (SSA) of 67° (range 60–80). Radiographic and clinical outcomes were measured. Mean time of follow-up was 3.8 years (range 1–10). Results Anatomical reduction was achieved in all cases. Good radiological results according to the Stulberg Classification (grade 1 + 2) and the Sphericity Deviation Score (< 30) were found in 9 out of 13 patients at the last follow-up. Clinical and functional outcome analysis revealed good results in 8 out of 10 patients (Harris Hip Score > 80). The quality of life measured by the Nottingham Health Profile (NHP) was described good in 10 out of 10 patients. Four out of 15 patients developed an AVN. Conclusions The modified Dunn procedure has a great potential to restore proximal femur geometry in severe chronic or acute on chronic SCFE. It should be considered only if there is no other possibility to restore proximal femur geometry, as is the case in severe slips, due to the risk of AVN.


2008 ◽  
Vol 28 (4) ◽  
pp. 444-451 ◽  
Author(s):  
Oskar Zupanc ◽  
Miran Križančič ◽  
Matej Daniel ◽  
Blaž Mavčič ◽  
Vane Antolič ◽  
...  

1991 ◽  
Vol 11 (5) ◽  
pp. 631-637
Author(s):  
Lee S. Segal ◽  
Richard S. Davidson ◽  
William W. Robertson ◽  
Denis S. Drummond

2017 ◽  
Vol 46 (2) ◽  
pp. 478-486 ◽  
Author(s):  
William Z. Morris ◽  
Ryan T. Li ◽  
Raymond W. Liu ◽  
Michael J. Salata ◽  
James E. Voos

Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity. While the exact cause of epiphyseal extension has not yet been determined, preliminary evidence suggests that epiphyseal extension may reflect a short-term adaptive response to provide stability to the physis at the long-term cost of the development of cam morphology. Commonly recognized causes of secondary cam deformity include frank slipped capital femoral epiphysis, Legg-Calve-Perthes disease, and deformity after fracture of the proximal femur. Recent studies also support subtle slipped capital femoral epiphysis as a unique and silent cause of a small percentage of subjects previously thought to have idiopathic cam deformity.


Author(s):  
D. R. Ramprasath ◽  
D. Kamaraj

<p class="abstract">Arthrodiastasis (using external fixator and distraction) has been used for various pathologies including deformity correction/stiff hip/slipped capital femoral epiphysis. Historically this has been used for treatment of Perthes disease. The purpose of our study is to evaluate efficacy of arthrodiastasis in management of stiff hip. A 15 year old boy with stiff hip presented with complaints of pain in the left hip for past 6 months. Radiologically the left proximal femur was found to be deformed with metaphyseal widening, sclerosis and arthritic changes. Hip spanning external fixator using limb reconstruction system was done. Distraction was done at a rate of 1 mm/day. After 2 months, fixator was removed. Hip was mobilized under anaesthesia. Good range of all movements was achieved. Arthrodiastasis seems to be a good option in young adolescent in whom total hip replacement needs to be delayed as much as possible.</p>


2019 ◽  
Vol 3 (4) ◽  
pp. 1-2
Author(s):  
Gharaibeh A

Slipped fem oral capital epiphysis is considered to be one of the most destructive conditions of hip joint during adolescence. The epiphysolysis of the femoral head was first defined in 1572 by the French surgeon Abrois Paré (1510 - 1590). The first authentic traumati c epiphysesolysis of the femoral head was described by Brousseau in 1867. It was in a 15 - year - old boy with multiple injuries after trauma with heavy carriage. Death occurred in a few hours, and was discovered by post - mortem examination. Complete separation of epiphysis of the femur head was found. The first mention of a non - traumatic form of epiphysolysis occurred in a fourteen years old boy later. In 1881, Fiorani reported fifteen cases of distorted hip joint with impaired adduction in children. He describ ed the deformity as a bend of the proximal part of the femur, which was based on rickets. With a high probability, some individua ls were coxa vara adolescentium . The first complete description of the disease was given by E Müller (1888) in his work “ About the bending of the femoral neck in the growth age ” Coxa vara adolescentium (CVA), epiphysesolysis of femural head or slipped femoral capital epiphysis represents a serious hip disease in the pubescent age at which the femoral proximal growth plate loses it s strength and influence mechanical forces, caused mainly by excessive body weight, the non - traumatic epiphysesolysis will occur. Symptoms like pain and twisting are initially vague, but they tend to escalate over time . The incidence of this disease is 0. 1 per one million, affect male more than female 2:1,4 in the rapid growth period 10 - 16 years old. Childhood obesity is the common cause of Slipped femoral capital epiphysis, then endocrine disorders and Down syndrome. Slipped femoral capital epiphysis has three grades first up to 33 degrees of slippage, second grade from 34 - 50% of slippage and the third degree more than 50%.Slipped femoral capital epiphysis, represents a serious disease of the puberty in the pubescent age at which the femoral proximal growth plate loses its strength and influence mechanical forces, caused mainly by excessive body weight, will occu r non - traumatic epiphysesolysis . Symptoms like pain and limping are initially vague, but they tend to escalate over time .


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