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Slip capital femoral epiphysis

James D Wylie, Eduardo N Novais
PURPOSE OF REVIEW: To review slipped capital femoral epiphysis (SCFE), with a focus on new insights into its etiology and evolving methods of operative fixation. RECENT FINDINGS: The epiphyseal tubercle and its size during adolescence are paramount to understanding the mechanism of SCFE. In chronic stable SCFE, the epiphysis rotates about the tubercle protecting the lateral epiphyseal vessels from disruption. In an acute unstable SCFE, the tubercle displaces, increasing the risk of osteonecrosis, also known as avascular necrosis (AVN)...
March 12, 2019: Current Reviews in Musculoskeletal Medicine
J Chomiak, M Ošťádal, P Dungl
PURPOSE OF THE STUDY To evaluate the results of treatment of acute and chronic severe slips of slipped capital femoral epiphysis. The tested hypothesis was that the results will be comparable with the methods using surgical hip dislocation. MATERIAL AND METHODS In the period 1996-2014, 26 patients were treated for severe slips ( >60°). Boys prevailed (2:1) and were older on average (the mean age 13.8 vs.12 years). Chronic stable slips prevailed (16 patients) and were followed by acute-on-chronic slips (7 patients) and with acute slips (3 patients)...
2019: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Elizabeth C Bond, Paul Phillips, Peter D Larsen, Lynette Hunt, Richard Willoughby
BACKGROUND: In recent years, there has been a trend toward more aggressive management of slipped capital femoral epiphysis (SCFE) with acute anatomical realignment; however, the literature is unclear with regard to the indications for this. QUESTIONS/PURPOSES: To collect long-term patient-reported outcome scores on a group of SCFE patients using modern hip scores. The second aim was to determine whether there is a threshold level of deformity beyond which patients have predictably poor outcomes following in situ pinning...
January 2019: Journal of Orthopaedic Surgery
Giuseppe Solarino, Luigi Zagra, Andrea Piazzolla, Arcangelo Morizio, Giovanni Vicenti, Biagio Moretti
BACKGROUND: Ceramic-on-ceramic (CoC) bearings due to their mechanical properties can be used in primary total hip arthroplasty (THA) especially in young patients requiring a long-lasting implant. The goal of this study is to analyze the results of a series of 200 consecutive CoC THAs in patients aged 50 years or less at the time of surgery. METHODS: A retrospective study was conducted on the first 200 consecutive CoC arthroplasties performed using the direct lateral approach on 105 females and 81 males (14 bilateral cases) with an average age of 44...
January 31, 2019: Journal of Arthroplasty
Imran Asad, Michelle Sin Lee
No abstract text is available yet for this article.
February 2019: Clinical Practice and Cases in Emergency Medicine
Wei Xiang Ng, Chung Yuan Kau, Vivienne Chien Lin Ho, Jordan Wei Peng Ng, Beatrice Jia Ying Lee, Nicole Kim Luan Lee, Kevin Boon Leong Lim
To investigate whether the timing of surgery and surgical technique affect the rate of osteonecrosis in unstable slipped capital femoral epiphysis (SCFE). This is a retrospective review of all unstable slips that were treated at our institution over 8.5 years with a minimum follow-up period of 12 months. Patients with stable slips were excluded from this analysis. Demographic data, time to surgery, and surgical technique were analyzed. Twenty-three unstable slips were included for study after excluding 40 stable slips...
February 21, 2019: Journal of Pediatric Orthopedics. Part B
Pamela Lang, Hemali Panchal, Erin M Delfosse, Mauricio Silva
There is limited information regarding the outcome of in-situ fixation of unstable slipped capital femoral epiphysis (U-SCFE). We aimed to report the outcome of a cohort of patients with U-SCFE that were treated with in-situ fixation, by comparing it to the outcome of patients with stable slipped capital femoral epiphysis (S-SCFE).After Institutional Review Board approval, a retrospective analysis of patients with SCFE that were treated with in-situ fixation at a single institution between 2005 and 2016 was performed...
January 29, 2019: Journal of Pediatric Orthopedics. Part B
Sulaiman F Almedaifer, Abdullah J AlShehri, Thamer S Alhussainan
Valgus slipped capital femoral epiphysis (SCFE) is very infrequent, and it is characterized by a superolateral displacement of the epiphysis on the metaphysis. To date, less than 100 cases of valgus SCFE have been described in the literature. Bilaterality of valgus SCFE is extremely rare, and it presents management challenges to the treating orthopedic surgeons. Herein, we report the case of an 11-year-old Saudi Arabian girl presented to clinic with a one-year history of bilateral hip pain and limping. Past medical history was negative for endocrinopathies, hemoglobinopathies, bone disorders, trauma or radiation therapy to the pelvis...
November 15, 2018: Curēus
Yi-Fan Huang, Li-Shen Wang, Shi Zhang, Yu-Hang Gao, Jian-Guo Liu, Xin Qi
RATIONALE: Slipped capital femoral epiphysis (SCFE) is a common hip problem in adolescents, usually individuals between 8 and 15 years old. Because of the frequent finding of growth abnormalities in affected children, various endocrine disturbances have been reported as the cause of the disease. However, there are few case reports of older patients in previous literature. To the best of our knowledge, congenital hypopituitarism with normal growth hormone (GH) level has not been reported...
January 2019: Medicine (Baltimore)
Chae Hoon Chung, Kyung Rae Ko, Joo Hwan Kim, Jong Sup Shim
BACKGROUND: Slipped capital femoral epiphysis (SCFEs) can be idiopathic or atypical (associated with renal failure, radiation therapy, and endocrine disorders). It is important to estimate the likelihood that atypical SCFE shows different clinical and radiographic characteristics and complications with typical SCFEs. METHODS: We retrospectively reviewed 53 patients (66 hips) with SCFEs managed between 1995 and 2016. Sex, age, weight, height, the duration of symptoms the laterality of the slip, and complications were recorded...
January 14, 2019: Journal of Pediatric Orthopedics
Fan Yang, Yongting Zhao, Jie Lv, Xia Sheng, Lihong Wang
17α-Hydroxylase/17,20-lyase deficiency (17-OHD) is a rare disease caused by mutations of the CYP17A1 gene. Slipped capital femoral epiphysis (SCFE) rarely occurs in adults. There are occasional reports of adrenal myelolipoma (AML) in 17-OHD. A 27-year-old Chinese female (46, XX) visited the hospital for SCFE and presented with continuous hypokalemia, absent spontaneous puberty, and hypertension. Hypergonadotropic hypogonadism was detected. The laboratory tests were consistent with 17-OHD. AML was considered based on the imaging examinations...
January 7, 2019: Gynecological Endocrinology
H Ucpunar, S K Tas, Y Camurcu, H Sofu, M Mert, A I Bayhan
Purpose: The aim of our explorative study was to compare the differences in the coronal alignments of the hip, knee and ankle on the slip side and non-slip sides in patients with slipped capital femoral epiphysis (SCFE). Methods: The study group consisted of 28 patients. On the full-length standing radiographs, measurements of articulo-trochanteric distance (ATD), neck-shaft angle (NSA), femoral offset, hip-knee-ankle axis, femur-tibial angle, mechanical axis deviation ratio (MAD-r), anatomical medial proximal femoral angle (aMPFA), mechanical lateral proximal femoral angle (mLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral distal femoral angle (mLDFA), knee joint line congruency angle, mechanical medial proximal tibial angle (mMPTA), mechanical lateral distal tibial angle (mLDTA), ankle joint line orientation angle (AJOA), and leg length discrepancy (LLD) were performed...
December 1, 2018: Journal of Children's Orthopaedics
Ryuji Tanaka, Yuji Yasunaga, Jiro Fujii, Takuma Yamasaki, Takeshi Shoji, Nobuo Adachi
BACKGROUND: Joint-preserving procedures should be considered as much as possible for hip disorders in pediatric and young patients. However, in patients with extensive osteonecrosis (ON) of the femoral head combined with severe collapse and advanced secondary osteoarthritis (OA), the optimal procedure has not been elucidated. This retrospective study aimed to investigate the postoperative outcomes of 11 patients who underwent transtrochanteric rotational osteotomy (TRO) alone or with a combination treatment for various hip disorders in young patients and to evaluate the usefulness of TRO...
December 13, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Till D Lerch, Eduardo N Novais, Florian Schmaranzer, Kai Ziebarth, Simon D Steppacher, Moritz Tannast, Klaus A Siebenrock
BACKGROUND: Prophylactic pinning of the asymptomatic and normal-appearing contralateral hip in patients with unilateral slipped capital femoral epiphysis (SCFE) remains controversial. Understanding the minimal 10-year clinical, functional, and radiographic outcomes of the contralateral asymptomatic hip in unilateral SCFE may be helpful in the decision regarding whether the benefits associated with potentially preventing a SCFE are outweighed by the risk of additional surgery. QUESTIONS/PURPOSES: Among patients with SCFE treated with prophylactic pinning of the asymptomatic and contralateral hip, we sought (1) to determine the complications and reoperations; (2) to evaluate the development of cam deformities and the frequency and severity of osteoarthritis progression; and (3) to characterize hip pain and function as measured by the Harris hip score (HHS) and the Hip Disability and Osteoarthritis Outcome Score (HOOS) at minimal 10-year followup...
December 13, 2018: Clinical Orthopaedics and related Research
Balasubramanian Balakumar, Sanjeev Madan
BACKGROUND: Management of avascular necrosis (AVN) of the femoral head in slipped capital femoral epiphysis (SCFE) is difficult. We proposed to ascertain if staged hip distraction could prevent collapse and recover the femoral head. METHODS: A retrospective review of the hip database retrieved 16 children with unstable SCFE and AVN. All underwent capital realignment by surgical dislocation followed by 2nd-stage hinged hip distraction. Patient demographics and radiographic parameters of deformity, AVN and arthritis were collected...
November 20, 2018: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Mason Uvodich, Richard Schwend, Ognjen Stevanovic, Will Wurster, Julia Leamon, Alec Hermanson
OBJECTIVE: To prospectively characterize pain locations in slipped capital femoral epiphysis (SCFE) and evaluate pain locations as predictors of a delay in diagnosis. STUDY DESIGN: This was an institutional review board approved prospective study of 110 children who underwent surgery for SCFE at a tertiary children's hospital between 2009 and 2015. Standardized pain diagrams were completed by 107 children. Pain zones were designated via a composite diagram. Hips without hip pain were categorized as atypical; hips with hip pain were typical...
November 16, 2018: Journal of Pediatrics
Kirit Singh, Avinash Kumar Kanodia, Peter Ross, Antonia Torgersen, Jamie Maclean, Graham Leese, Kismet Hossain-Ibrahim
An 18-year-old man who underwent bilateral pinning of his hip joints after a left unstable Slipped Capital Femoral Epiphysis (right pinned prophylactically) was noted to have delayed secondary sexual characteristics and post-operative diabetes insipidus. The patient also described a history of fatigue, headache and polydipsia for the past 4 years. Endocrine investigations revealed reduced androgen levels, hypocortisolism, a borderline normal Serum ACE and secondary hypothyroidism. Magnetic Resonance Imaging of the pituitary gland identified an enhancing mass and a thickened stalk which trans-nasal endoscopic biopsy found to be necrotic with pus...
November 19, 2018: British Journal of Neurosurgery
David R Maldonado, Itay Perets, Brian H Mu, Victor Ortiz-Declet, Austin W Chen, Ajay C Lall, Benjamin G Domb
BACKGROUND: Hip arthroscopy for the treatment of instability in the setting of borderline dysplasia is controversial. Capsular management in such cases is an important consideration, and plication has been described as a reliable technique, with good midterm outcomes reported when indications are appropriate. HYPOTHESIS: Patients with borderline dysplasia who have a lower lateral center-edge angle (LCEA) and greater age will be at a higher risk of failure after arthroscopic capsular plication...
December 2018: American Journal of Sports Medicine
A C C Angélico, L M Garcia, T R Icuma, C F Herrero, D A Maranho
AIMS: The aims of this study were to evaluate the abductor function in moderate and severe slipped capital femoral epiphysis (SCFE), comparing the results of a corrective osteotomy at the base of the femoral neck and osteoplasty with 1) in situ epiphysiodesis for mild SCFE, 2) contralateral unaffected hips, and 3) hips from healthy individuals. PATIENTS AND METHODS: A total of 24 patients (mean age 14.9 years (sd 1.6); 17 male and seven female patients) with moderate or severe SCFE (28 hips) underwent base of neck osteotomy and osteoplasty between 2012 and 2015...
November 2018: Bone & Joint Journal
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