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Slip capital femoral epiphysis

Moez Chargui, Amira Dhouib, Fabiana Esposito, Vasiliki Spyropoulou, Christina Steiger, Romain Dayer, Dimitri Ceroni
CASE: We report the case of an 11-year-old girl who developed osteonecrosis of the femoral head in the radiographically normal, asymptomatic left hip that had been fixed prophylactically in the context of a slipped capital femoral epiphysis (SCFE) that had been detected on the contralateral hip. The etiology of the osteonecrosis remains unknown. CONCLUSION: This case report demonstrates that prophylactic fixation of a radiographically normal, asymptomatic hip in the context of an SCFE on the contralateral side has the potential for substantial complications...
August 8, 2018: JBJS Case Connector
Afshin Taheriazam, Amin Saeidinia
Total hip arthroplasty is one of the best treatments for restoring function and activity in young patients with advanced joint diseases. One-Stage Bilateral Total Hip Arthroplasty (BTHA) offers many advantages, which are important to younger patients and diminished costs and time in comparison with sequential THA. There is currently much concern about the safety of this procedure. The current study was designed to provide more information regarding THA in patients aged 30 years old or younger. Between April 2010 and September 2015, arthroplasty procedures were performed on 180 patients at the surgical centers of Erfan and Milad, Tehran, Iran...
June 14, 2018: Orthopedic Reviews
Panayiotis D Megaloikonomos, Andreas F Mavrogenis, Georgios N Panagopoulos, Vasilios G Igoumenou, Giannis Giakas, Christos Zampakides, Dimitrios Pasparakis
PURPOSE: To compare longitudinal growth and cam deformity of the proximal femur after treatment for slipped capital femoral epiphysis (SCFE) with one screw versus two smooth pins. METHODS: We studied 43 patients (29 males, 14 females; mean age, 12.1 years; range, 9.5-14 years) with idiopathic unilateral SCFE treated with in situ fixation with one cannulated screw (group A, n = 23) or two smooth pins (group B, n = 20). Anteroposterior and frog-leg radiographs of the pelvis were evaluated for each patient at initial presentation, post-operatively and at physeal closure...
July 23, 2018: International Orthopaedics
Ilya M Gutman, Thomas E Niemeier, Shawn R Gilbert
BACKGROUND: Large national databases have been increasingly used in recent years to determine the rate of adverse events and identify factors associated with altered surgical outcomes. This can be especially useful to evaluate rare events such as 30-day mortality. Despite differences between national pediatric databases, there have been no comparison studies in the pediatric orthopaedic population. METHODS: The Healthcare Cost and Utilization Project's Kids' Inpatient Database (KID) along with the American College of Surgeons National Surgical Quality Improvement Program Pediatric (NSQIP Pediatric) databases were queried to identify common pediatric orthopaedic procedures for humeral fractures, scoliosis, slipped capital femoral epiphysis, and femoral fractures during a single year...
July 2, 2018: Journal of Pediatric Orthopedics
G T Fedorak, D C DeRosa, A K Brough, R H Miyamoto
Purpose: Previous work has examined the impact of delay of diagnosis in slipped capital femoral epiphysis (SCFE) but not the impact of delay in treatment after radiographic diagnosis. Due to requirements for long distance transportation from less developed regions for many of our patients, our hospital was able to study variation in time between diagnosis and surgery for SCFE, as related to slip severity. Methods: This is a retrospective review of patients treated for SCFE between 2005 and 2014 at a tertiary care paediatric hospital...
June 1, 2018: Journal of Children's Orthopaedics
Daniel A Maranho, Patricia E Miller, Eduardo N Novais
BACKGROUND: A rotational mechanism of slipped capital femoral epiphysis (SCFE) in which the epiphyseal tubercle acts as a fulcrum has been recently described. However, there is limited radiographic evidence supporting this theory. We aimed to investigate whether a radiographic lucency around the epiphyseal tubercle (peritubercle lucency sign) could be observed before or at the diagnosis of a subsequent slip in patients initially presenting with unilateral SCFE. METHODS: We evaluated 70 patients with unilateral SCFE who were followed until a contralateral slip was diagnosed, and 180 patients with unilateral SCFE who had no contralateral slip until skeletal maturity between 2000 and 2017...
August 2018: Journal of Pediatric Orthopedics
Junting Zang, Katsufumi Uchiyama, Mitsutoshi Moriya, Zhengwei Li, Kensuke Fukushima, Takeaki Yamamoto, Jianguo Liu, Wei Feng, Naonobu Takahira, Masashi Takaso
Intracapsular cuneiform osteotomy was initially introduced to restore the morphology of the proximal femur after slipped capital femoral epiphysis (SCFE). However, whether this procedure results in a higher risk of avascular necrosis (AVN) or lower incidence of cam deformity than in-situ pinning is unclear. The aim of this study was to compare the outcomes of intracapsular cuneiform osteotomy and in-situ pinning to treat SCFE in children. Twenty-three children who suffered from SCFE underwent either intracapsular cuneiform osteotomy (eight patients, eight hips) or in-situ pinning (15 patients, 18 hips) between 2006 and 2014...
June 1, 2018: Journal of Pediatric Orthopedics. Part B
Daniel J Sucato
The treatment of slipped capital femoral epiphysis (SCFE) in North America has seen a change over the past 15 to 20 years due to a better understanding of the blood flow supplying the femoral head, the ability to monitor the pressure/flow in real time and greater access to the deformity with the development of surgical approaches providing that access. These advances have mainly affected the treatment of the unstable SCFE to mitigate the risk of avascular necrosis but have also been utilized for the stable SCFE when severe deformity remains...
July 2018: Journal of Pediatric Orthopedics
Jonathan Wright, Manoj Ramachandran
Treatment of slipped capital femoral epiphysis remains a contentious and debated issue. The opinion for the correct method of treatment can differ not only between different continents and nations, but also between units and surgeons within individual units. We aim to review the European perspective on the treatment of slipped capital femoral epiphysis and consider the trends for treatment among the European orthopaedic surgical community.
July 2018: Journal of Pediatric Orthopedics
Eduardo N Novais, Daniel A Maranho, Travis Heare, Ernest Sink, Patrick M Carry, Courtney O'Donnel
PURPOSE: The aim of this study was to compare clinical outcomes and radiographic correction after modified Dunn procedure versus inadvertent closed reduction and percutaneous pinning for the treatment of unstable slipped capital femoral epiphysis (SCFE). METHODS: We evaluated 45 patients with unstable SCFE treated using the modified Dunn procedure (n = 27) or percutaneous pinning (n = 18) during a minimum follow-up of one year. Clinical outcomes were assessed using the Heyman and Herndon scores...
May 24, 2018: International Orthopaedics
Jennifer K Hurry, Saad Rehan, Alan J Spurway, Elise K Laende, Janie L Astephen Wilson, Karl J Logan, Michael J Dunbar, Ron El-Hawary
Physeal closure after slipped capital femoral epiphysis fixation can be difficult to assess on two-dimensional conventional radiographs. Radiostereometric analysis offers improved motion detection over conventional radiography, whereas the EOS biplanar imager provides a means for low radiation weight-bearing images. This phantom study assessed the reliability of measuring motion using radiostereometric analysis in the EOS using a slipped capital femoral epiphysis model. The accuracy and precision were better than 0...
May 14, 2018: Journal of Pediatric Orthopedics. Part B
Andy B Awwad, William L Hennrikus, Douglas G Armstrong
Alternative medicine in pediatrics is expanding, with chiropractic now a common choice for families seeking alternative medical care. Currently, there is sparse information in the literature exploring the role of chiropractic in orthopaedic pathology. The objective of this case series is to present pediatric patients who received treatment from chiropractors and orthopaedic physicians as well as to review the respective existing research. Data collected included chiropractic diagnosis, orthopaedic diagnosis, imaging studies, treatments, and complications...
December 0: Journal of Surgical Orthopaedic Advances
A Lam, S A Boenerjous, Y Lo, J M Abzug, J Kurian, M C Liszewski, D E Sanderson, J M Scholnick, B H Taragin, J A Gomez, N Y Otsuka, R Hanstein
Purpose: To evaluate sensitivity, specificity and accuracy of a radiographic slipped capital femoral epiphysis (SCFE)-diagnosis among medical specialists. Methods: Three paediatricians, three paediatric radiologists and three paediatric orthopaedic surgeons completed two rounds of a survey of anteroposterior and frog-leg lateral radiographs of patients with a diagnosis of SCFE (25), femoroacetabular impingement (four), Legg-Calvé-Perthes (11) or no hip pathology (ten)...
April 1, 2018: Journal of Children's Orthopaedics
E N Novais, K-P Kienle, P E Miller, G Bowen, Y-J Kim, S D Bixby
Purpose: To determine age-and gender-dependent variation of epiphyseal tilt and epiphyseal angle using CT in adolescents without hip pathology. Methods: Pelvic CT scans were obtained in 132 adolescents for evaluation of abdominal pain. Radially oriented planes around the femoral neck were reformatted and the epiphyseal tilt and angle were measured in the anterior, anterosuperior and superior planes. Variations in the tilt angle and epiphyseal angle were assessed by age group from 12 to 18 years and gender by using a linear mixed model analysis...
April 1, 2018: Journal of Children's Orthopaedics
D C Perry, J G Wright, S Cooke, A Roposch, M S Gaston, N Nicolaou, T Theologis
Aims: High-quality clinical research in children's orthopaedic surgery has lagged behind other surgical subspecialties. This study used a consensus-based approach to identify research priorities for clinical trials in children's orthopaedics. Methods: A modified Delphi technique was used, which involved an initial scoping survey, a two-round Delphi process and an expert panel formed of members of the British Society of Children's Orthopaedic Surgery. The survey was conducted amongst orthopaedic surgeons treating children in the United Kingdom and Ireland...
May 1, 2018: Bone & Joint Journal
James M Hartford, Bradley P Graw, Sara B Knowles, Dominick L Frosch
BACKGROUND: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach. METHODS: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Radiographs were evaluated for femoral neck angle, femoral neck cut ratio (FNCR), and DORR ratio...
July 2018: Journal of Arthroplasty
Matthew R Schmitz, Todd J Blumberg, Susan E Nelson, Julieanne P Sees, Wudbhav N Sankar
BACKGROUND: Developmental dysplasia of the hip (DDH), which encompasses a wide spectrum of disease from mild dysplasia to frank dislocation, is one of the most common developmental deformities of the lower extremities and one of the leading causes of future osteoarthritis and hip arthroplasty. Legg-Calvé-Perthes disease (LCPD) results from a vascular insult to the growing femoral epiphysis, which in turn can create permanent morphologic changes to the hip joint. Slipped capital femoral epiphysis (SCFE) occurs when the proximal femoral physis fails allowing the epiphysis to displace in relation to the metaphysis...
July 2018: Journal of Pediatric Orthopedics
Eric J Rebich, Stephanie S Lee, John A Schlechter
BACKGROUND: Children with slipped capital femoral epiphysis (SCFE) are often seen by an array of medical professionals prior to diagnosis. Patients with mild slips, slips with knee pain, or bilateral slips can occasionally present a diagnostic challenge that increases the risk of a delay in diagnosis and associated complications. OBJECTIVES: This study introduces a new radiographic parameter, which we refer to as the S-sign, and analyzes its diagnostic utility on a frog-leg lateral radiograph...
June 2018: Journal of Emergency Medicine
Hanifi Ucpunar, Ismet Yalkin Camurcu, Serda Duman, Esra Ucpunar, Hakan Sofu, Avni Ilhan Bayhan
Background and purpose - Patients with slipped capital femoral epiphysis (SCFE) are phenotypically overweight or obese and may therefore require clinical follow-up of obesity-related disorders. We evaluated obesity-related disorders such as dyslipidemia, type 2 diabetes mellitus (DM), and vitamin-D deficiency during the postoperative period in patients with SCFE. Patients and methods - 51 patients who were operated and followed-up for SCFE and 62 healthy adolescents without SCFE (control group) were included in this retrospective study...
June 2018: Acta Orthopaedica
Keerthana Sankar, Wade Kyono, Corey Raffel, Theodore Nicolaides
Slipped capital femoral epiphysis (SCFE) is a fracture that results from displacement of the proximal femoral epiphysis from the femoral neck. SCFE can be caused by various endocrinopathies that lead to bone weakening in both adult and pediatric patients. We report a rare case of suprasellar germinoma presenting with SCFE in an 11-year-old female patient. The findings of this case further support the need to consider pituitary lesions as the underlying cause of endocrine deficiences leading to SCFE.
December 16, 2017: Curēus
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