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 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The risk of chondrolysis and avascular necrosis (AVN) in black children treated for slipped capital femoral epiphysis (SCFE) is controversial. A retrospective study was conducted of 29 black patients (44 hips) treated for SCFE at Kings County Hospital, Brooklyn, New York, to evaluate our own experience. All patients were treated with in situ pinning. The overall rates of chondrolysis and AVN were 6.8 and 4.5%, respectively. Fifty-two percent of patients had bilateral SCFE. Obesity was extremely common and correlated significantly with bilateral disease. Obesity did not correlate directly with a higher incidence of chondrolysis or AVN. Adherence to technical details described should reduce complications further.
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PMID:Slipped capital femoral epiphysis in black children: incidence of chondrolysis. 161 84

Three young people, a boy aged 15 years and two girls aged 9 years and 13 years, had already suffered groin pain and knee pain for many months. They exhibited an antalgic walk, diminished function of the hip and radiographic signs of a slipped capital femoral epiphysis (SCFE). The complaints disappeared following in situ fixation with one or more screws. Epiphysiolysis of the caput femoris through the growth plate is a disorder of the growing hip. It is the most prevalent hip disease in adolescents. Obese boys are the most commonly affected. The aetiology is not known. The later SCFE is diagnosed and treated, the greater the chance of premature coxarthrosis. Avascular necrosis and chondrolysis are complications that can arise as a result of the operation.
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PMID:[Pain and gait problems in 3 (almost) adolescents with a dislocated hip]. 1145 Jun

The slipped capital femoral epiphysis (SCFE) is defined as a nontraumatic epiphyseal separation and slipping of the proximal femoral epiphysis, which usually occurs during the adolescent growth spurt. Slipping of the upper femoral epiphysis may be classified as acute, chronic, and acute on chronic. The etiology of the disease is still not fully understood but seems to be multifactorial. The typical SCFE during puberty has to be differentiated from the atypical form, which may be associated with an endocrinological disorder or with its therapy. The typical SCFE may be found in male patients, with increased height and weight. It is likely that the growth rate is slightly accelerated before slippage. Obesity is often associated with a decreased femoral anteversion accounting for abnormal mechanical shear forces at the growth plate. SCFE is treated surgically. Surgical methods are administered according to the degree of disease. Because of possible alterations of blood supply to the femoral head, acute SCFE is an emergency. Following SCFE, complications such as chondrolysis and avascular necrosis are feared.
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PMID:[Slipped capital femoral epiphysis and overweight]. 1591 60

Slipped upper femoral epiphysis (SUFE) is a multifactorial condition usually affecting adolescents. Obesity is one risk factor, and as this is increasing the incidence of SUFE is likely to rise. Diagnosis and treatment are usually straightforward and carried out by orthopaedic surgeons. However, the recognition of post-treatment complications poses a much greater challenge. This article focuses on possible complications of surgical treatment of SUFE particularly. Chondrolysis, avascular necrosis, as well as other complications of treatment and conditions leading to premature osteoarthritis are discussed. Checklists for a systematic approach to post-treatment imaging are provided.
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PMID:Slipped upper femoral epiphysis: imaging of complications after treatment. 1806 88

Slipped capital femoral epiphysis (SCFE) is rare in children aged less than 10 years, and its management in this age group raises a number of different considerations. We present a series of 10 children aged less than 10 years who presented with SCFE to our institution between 1993 and 2005. Case notes and radiographic review were carried out. There were six boys and four girls, with an age range of 5.2-9.9 years. Mean follow-up was 50 months (22-90). The mean duration of symptoms was 54 days (1-196). Five cases were bilateral. The second slip occurred at a mean interval of 14 months (11-22) after the first slip. There were 12 stable and three unstable slips. One child had hypothyroidism and another oculocutaneous albinism. The remaining children had normal genetic and endocrine profiles. Six children were severely obese, one obese, two overweight, and one within the normal range. Multiple pins were used in nine hips and a single cannulated screw was used in six hips. Complications include loss of fixation in five hips treated with multiple pins, which were revised between 2 months and 2 years from the initial surgery, and one superficial wound infection. There were no cases of avascular necrosis or chondrolysis. In conclusion, obesity is closely related to the development of SCFE in younger children. A technique that preserves physeal growth should be used for in-situ fixation. Multiple pins preserve capital femoral physeal growth, but at the cost of a high complication rate. Strong consideration for prophylactic pinning of the contralateral hip is recommended.
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PMID:Slipped capital femoral epiphysis in children aged less than 10 years. 1973 10

Slipped capital femoral epiphysis is the most common hip disorder in adolescents, and it has a prevalence of 10.8 cases per 100,000 children. It usually occurs in children eight to 15 years of age, and it is one of the most commonly missed diagnoses in children. Slipped capital femoral epiphysis is classified as stable or unstable based on the stability of the physis. The condition is associated with obesity and growth surges, and it is occasionally associated with endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Patients usually present with limping and poorly localized pain in the hip, groin, thigh, or knee. Diagnosis is confirmed by bilateral hip radiography, which needs to include anteroposterior and frog-leg lateral views in patients with stable slipped capital femoral epiphysis, and anteroposterior and cross-table lateral views in patients with the unstable form. The goals of treatment are to prevent slip progression and avoid complications such as avascular necrosis and chondrolysis. Stable slipped capital femoral epiphysis is usually treated using in situ screw fixation. Treatment of unstable slipped capital femoral epiphysis usually involves in situ fixation, but there is controversy about the timing of surgery, value of reduction, and whether traction should be used.
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PMID:Slipped capital femoral epiphysis: diagnosis and management. 2067 90

Slipped capital femoral epiphysis (SFCE) is a disorder of the hip, characterized by a displacement of the capital femoral epiphysis from the metaphysic through the femoral growth plate. The epiphysis slips posteriorly and inferiorly. SCFE occurs during puberty and metabolic and epidemiologic risk factors, such as obesity are frequently found. Most chronic slips are diagnosed late. Sagittal hip X-rays show epiphysis slip. In case of untreated SCFE, a slip progression arises with an acute slip risk. Treatment is indicated to prevent slip worsening. The clinical and radiological classification is useful to guide treatment and it is predictive of the prognosis. In situ fixation of stable and moderately displaced SCFE with cannulated screws gives excellent results. Major complications are chondrolysis and osteonecrosis and the major sequelae are femoroacetabular impingement and early arthritis.
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PMID:[Slipped capital femoral epiphysis]. 2816 Dec 30

Slipped capital femoral epiphysis (SCFE) is the most common hip disorder in adolescents, occurring in 10.8 per 100,000 children. SCFE usually occurs in those eight to 15 years of age and is one of the most commonly missed diagnoses in children. SCFE is classified as stable or unstable based on the stability of the physis. It is associated with obesity, growth spurts, and (occasionally) endocrine abnormalities such as hypothyroidism, growth hormone supplementation, hypogonadism, and panhypopituitarism. Patients with SCFE usually present with limping and poorly localized pain in the hip, groin, thigh, or knee. Diagnosis is confirmed by bilateral hip radiography, which should include anteroposterior and frog-leg views in patients with stable SCFE, and anteroposterior and cross-table lateral views in unstable SCFE. The goals of treatment are to prevent slip progression and avoid complications such as avascular necrosis, chondrolysis, and femoroacetabular impingement. Stable SCFE is usually treated using in situ screw fixation. Treatment of unstable SCFE also usually involves in situ fixation, but there is controversy about timing of surgery and the value of reduction. Postoperative rehabilitation of patients with SCFE may follow a five-phase protocol.
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PMID:Slipped Capital Femoral Epiphysis: Diagnosis and Management. 2867 25

Slipped capital femoral epiphysis (SCFE), a common cause of adolescent hip pain, is a displacement of the femoral head through the proximal femoral physis. The exact etiology of SCFE is unknown, but both biochemical and biomechanical factors, including obesity, femoral retroversion, increased physeal obliquity, puberty, and endocrinopathies, play a role. Patients often present with hip, groin, or knee pain and an antalgic gait. On physical examination, obligate external rotation of the lower limb with passive hip flexion is a hallmark of SCFE. The diagnosis is confirmed with radiographs, with advanced imaging reserved for atypical presentations. Any degree of SCFE is an indication for internal stabilization. Percutaneous in situ fixation remains the gold-standard treatment for slipped capital femoral epiphysis. The procedure is performed with the following steps: (1) the patient is positioned supine on a fracture table with the contralateral lower limb in the hemilithotomy position; (2) a 1-cm longitudinal incision is made over the anterolateral aspect of the proximal part of the femur; (3) under fluoroscopic guidance, a guidewire is advanced freehand into the "center-center" of the epiphysis, stopping approximately 3 mm short of the articular surface; (4) the guidewire is overdrilled, and a 6.5-mm partially threaded cannulated screw of appropriate length is inserted into the epiphysis; (5) the proximal part of the femur is brought through a full range of internal-external rotation under fluoroscopy to confirm that the screw has not violated the joint cavity; and (6) the wound is closed in layers and a sterile dressing is applied. Postoperatively, the patient's weight-bearing status is advanced on the basis of the stability of the SCFE. Radiographic follow-up is performed at six-month intervals to monitor the contralateral hip until skeletal maturity. Treatment outcomes and complications such as osteonecrosis and chondrolysis correlate with the severity and stability of the slip on presentation. Long-term follow-up has shown good-to-excellent outcomes after in situ screw fixation of stable slips.
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PMID:Percutaneous in Situ Fixation of Slipped Capital Femoral Epiphysis. 3023 21