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https://www.readbyqxmd.com/read/28382187/ultrasonographic-diagnosis-of-slipped-capital-femoral-epiphysis
#1
Manikandan Palaniappan, Venkatraman Indiran, Prabakaran Maduraimuthu
BACKGROUND: Slipped capital femoral epiphysis (SCFE), a fracture through the physis with resultant slip of the epiphysis, is the most common hip abnormality in adolescents and is a major cause of early osteoarthritis. Plain radiograph is the initial modality used to evaluate patients with painful hip joints. Ultrasonography and magnetic resonance imaging (MRI), which do not involve radiation exposure, have also been used. This case report supports the view that ultrasound can be used as an initial, cost-effective and radiation-free modality for the evaluation of suspected SCFE...
2017: Polish Journal of Radiology
https://www.readbyqxmd.com/read/28328562/treatment-of-unstable-versus-stable-slipped-capital-femoral-epiphysis-using-the-modified-dunn-procedure
#2
Richard L Davis, Walter P Samora, Freddie Persinger, Kevin E Klingele
BACKGROUND: The modified Dunn procedure (open subcapital realignment via a surgical dislocation approach) has been shown to be a safe and effective way of treating acute, unstable slipped capital femoral epiphysis (SCFE). There is a paucity of literature comparing the modified Dunn procedure in stable SCFE. The purpose of this study was to compare acute, unstable versus chronic, stable SCFE managed with the modified Dunn procedure. METHODS: A retrospective chart review was performed on 44 skeletally immature patients who underwent the modified Dunn procedure for SCFE...
March 21, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28288077/comparison-of-surgical-outcomes-between-a-triplane-proximal-femoral-osteotomy-and-the-modified-dunn-procedure-for-stable-moderate-to-severe-slipped-capital-femoral-epiphysis
#3
Jakub Sikora-Klak, James D Bomar, Christina N Paik, Dennis R Wenger, Vidyadhar Upasani
BACKGROUND: Recent studies have demonstrated the intra-articular cartilage and labral damage that can occur from the proximal femoral cam-like deformity of a moderate to severe slipped capital femoral epiphysis (SCFE). The approach to treating this deformity in a symptomatic Loder stable hip is controversial. The purpose of this study was to compare radiographic outcomes, complication rates, and revision rates between Imhauser type triplane proximal femoral osteotomy (TPFO) and the modified Dunn procedure (MDP)...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28244926/biomechanical-evaluation-of-the-depth-of-resection-during-femoral-neck-osteoplasty-for-anterior-impingement-following-slipped-capital-femoral-epiphysis
#4
Kevin M Dale, Geoffrey T Burns, Ying Li
BACKGROUND: Femoroacetabular impingement as a result of slipped capital femoral epiphysis (SCFE) has been treated traditionally with a proximal femoral osteotomy, but open and arthroscopic femoral osteoplasty is becoming increasingly popular. Cam lesions result from excess bone primarily at the anterolateral femoral head-neck junction. SCFEs result from posterior and inferior slippage of the femoral epiphysis, causing the metaphysis to move anteriorly. This study's purpose was to compare fourth-generation sawbones standard femurs with SCFE femurs to determine whether bone resection from the anterior metaphysis results in similar biomechanical properties...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28229355/femoral-shaft-osteotomy-for-obligate-outward-rotation-due-to-scfe
#5
Peter M Stevens, Lucas Anderson, Bruce A MacWilliams
Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement...
April 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28194709/high-survivorship-and-little-osteoarthritis-at-10-year-followup-in-scfe-patients-treated-with-a-modified-dunn-procedure
#6
Kai Ziebarth, Milan Milosevic, Till D Lerch, Simon D Steppacher, Theddy Slongo, Klaus A Siebenrock
BACKGROUND: The modified Dunn procedure has the potential to restore the anatomy in hips with slipped capital femoral epiphyses (SCFE) while protecting the blood supply to the femoral head and minimizing secondary impingement deformities. However, there is controversy about the risks associated with the procedure and mid- to long-term data on clinical outcomes, reoperations, and complications are sparse. QUESTIONS/PURPOSES: Among patients treated with a modified Dunn procedure for SCFE, we report on (1) hip pain and function as measured by the Merle d'Aubigné and Postel score, Drehmann sign, anterior impingement test, limp, and ROM; (2) the cumulative survivorship at minimum 10-year followup with endpoints of osteoarthritis (OA) progression (at least one Tönnis grade), subsequent THA, or a Merle d'Aubigné and Postel score < 15; (3) radiographic anatomy of the proximal femur measured by slip angle, α angle, Klein line, and sphericity index; and (4) the risk of subsequent surgery and complications...
April 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28194387/arthroscopic-subcapital-realignment-osteotomy-in-chronic-and-stable-slipped-capital-femoral-epiphysis-early-results
#7
Bruno Dutra Roos, Marcelo Camargo de Assis, Milton Valdomiro Roos, Antero Camisa Júnior, Ezequiel Moreno Ungaretti Lima, Rodolfo Cavanus Pagani
OBJECTIVE: This study aimed to evaluate the clinical and radiographic outcomes, as well as the complications of arthroscopic subcapital realignment osteotomy in chronic and stable slipped capital femoral epiphysis (SCFE). As indicated by the literature review, this is the first time this type of arthroscopic osteotomy was described. METHODS: Between June 2012 and December 2014, seven patients were submitted to arthroscopic subcapital realignment osteotomy in chronic and stable SCFE...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28176673/surgical-hip-dislocation-in-treatment-of-slipped-capital-femoral-epiphysis
#8
Mohammed Elmarghany, Tarek M Abd El-Ghaffar, Mahmoud Seddik, Ahmed Akar, Yousef Gad, Eissa Ragheb, Alessandro Aprato, Alessandro Massè
BACKGROUND: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666-679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI) [Leunig M, Slongo T, Ganz R (2008) Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis...
2017: SICOT-J
https://www.readbyqxmd.com/read/28161230/-slipped-capital-femoral-epiphysis
#9
C Klein, E Haraux, J Leroux, R Gouron
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...
February 1, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28154765/valgus-slipped-capital-femoral-epiphysis-in-patient-with-hypopituitarism
#10
Yoshihiro Kotoura, Yasuhiro Fujiwara, Tatsuro Hayashida, Koji Murakami, Satoshi Makio, Yuichi Shimizu, Yoshinobu Oka, Wook-Choel Kim, Taku Ogura, Toshikazu Kubo
Slipped capital femoral epiphysis (SCFE) is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head...
2017: Case Reports in Orthopedics
https://www.readbyqxmd.com/read/28106675/treatment-of-slipped-capital-femoral-epiphysis-with-the-modified-dunn-procedure-a-multicenter-study
#11
Masquijo J Javier, Allende Victoria, D'Elia Martín, Miranda Gabriela, Fernández Claudio A
INTRODUCTION: Treatment of moderate to severe slipped capital femoral epiphysis (SCFE) is controversial. Over the last years, 3 institutions in Argentina adopted the modified Dunn procedure for capital realignment in selected cases of SCFE. Our aim in this study was to evaluate the clinical outcome and the rate of complications of patients who had undergone surgical hip dislocation and capital realignment. METHODS: A multicenter retrospective cohort study of patients who received the modified Dunn procedure from January 2009 to 2013 was performed...
January 18, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28079739/opinion-survey-of-members-of-british-society-of-children-s-orthopaedic-surgery-related-to-specific-case-scenarios-in-slipped-capital-femoral-epiphysis
#12
Bakur A Jamjoom, Daniel Butler, Simon Thomas, Manoj Ramachandran, Stephen Cooke
The aim of this study was to assess contemporary management of slipped capital femoral epiphysis (SCFE) by surveying members of the British Society of Children's Orthopaedic Surgery (BSCOS). A questionnaire with five case vignettes was used. Two questions examined the timing of surgery for an acute unstable SCFE in a child presenting at 6 and 48 h after start of symptoms. Two further questions explored the preferred method of fixation in mild and severe stable SCFE. The final question examined the management of the contralateral normal hip...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28053252/instability-of-the-hip-after-anatomical-re-alignment-in-patients-with-a-slipped-capital-femoral-epiphysis
#13
REVIEW
A Aprato, M Leunig, A Massé, T Slongo, R Ganz
AIMS: Several studies have reported the safety and efficacy of subcapital re-alignment for patients with slipped capital femoral epiphysis (SCFE) using surgical dislocation of the hip and an extended retinacular flap. Instability of the hip and dislocation as a consequence of this surgery has only recently gained attention. We discuss this problem with some illustrative cases. MATERIALS AND METHODS: We explored the literature on the possible pathophysiological causes and surgical steps associated with the risk of post-operative instability and articular damage...
January 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/27920593/slipped-capital-femoral-epiphysis-and-primary-hyperparathyroidism-a-case-report
#14
Anas A Alghamdi, Maswood M Ahmad, Mussa H Almalki
The aim of reporting this case is to highlight the association of two disorders, primary hyperparathyroidism (PHPT) and slipped capital femoral epiphysis (SCFE). They are usually seen in two different age groups and rarely together. PHPT is a rare cause of SCFE and only 10 cases have been reported in the literature worldwide. The patient in our report is a 13-year-old girl who presented to our clinic with bilateral knee pain and a waddling gait. Subsequent investigations showed that she had PHPT and SCFE with low bone mass...
2016: Clinical Medicine Insights. Endocrinology and Diabetes
https://www.readbyqxmd.com/read/27817118/continued-growth-after-fixation-of-slipped-capital-femoral-epiphysis
#15
Per Holmdahl, Torsten Backteman, Aina Danielsson, Johan Kärrholm, Jacques Riad
PURPOSE: When treating slipped capital femoral epiphysis (SCFE), a smooth pin with a hook or a short threaded screw can be used to allow further growth, which could be important to prevent the development of impingement and early arthritis. The purpose of this investigation was to measure growth in three dimensions after fixation of SCFE. METHODS: Sixteen participants with unilateral SCFE, nine girls and seven boys with a median age of 12.0 years (range 8.4-15...
December 2016: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/27662386/capital-femoral-epiphyseal-extension-may-confer-physeal-stability-in-slipped-capital-femoral-epiphysis
#16
William Z Morris, Joshua K Napora, Keegan T Conry, Raymond W Liu
BACKGROUND: Factors including obesity and morphologic parameters around the hip that increase physeal stress are associated with an increased risk of slipped capital femoral epiphysis (SCFE). Recent evidence suggests that superior epiphyseal extension may confer stability to the physis and help protect against SCFE. The purpose of this study is to investigate the relationship between epiphyseal extension and SCFE using an age-matched and sex-matched cohort study. METHODS: We generated 2 separate cohorts for comparison: 89 patients with unilateral SCFE and 89 healthy subjects with no evidence of hip disease or deformity...
September 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/27650993/iatrogenic-hip-instability-is-a-devastating-complication-after-the-modified-dunn-procedure-for-severe-slipped-capital-femoral-epiphysis
#17
MULTICENTER STUDY
Vidyadhar V Upasani, Oliver Birke, Kevin E Klingele, Michael B Millis
BACKGROUND: The modified Dunn procedure facilitates femoral capital realignment for slipped capital femoral epiphysis (SCFE) through a surgical hip dislocation approach. Iatrogenic postoperative hip instability after this procedure has not been studied previously; however, we were concerned when we observed several instances of this serious complication, and we wished to study it further. QUESTIONS/PURPOSES: The purpose of this study was to evaluate the frequency, timing, and clinical presentation (including complications) associated with iatrogenic instability after the modified Dunn procedure for SCFE...
April 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27629912/is-the-timing-of-surgery-associated-with-avascular-necrosis-after-unstable-slipped-capital-femoral-epiphysis-%C3%A2-a-multicenter-study
#18
Yusuke Kohno, Yasuharu Nakashima, Toshio Kitano, Taichi Irie, Atsushi Kita, Tomoyuki Nakamura, Hirosuke Endo, Yosuke Fujii, Takayuki Kuroda, Shigeru Mitani, Hiroshi Kitoh, Masaki Matsushita, Tadashi Hattori, Koji Iwata, Yukihide Iwamoto
BACKGROUND: An unstable slipped capital femoral epiphysis (SCFE) is associated with a high rate of avascular necrosis (AVN). The etiology of AVN seems to be multifactorial, although it is not thoroughly known. The aims of our study were to determine the rate of AVN after an unstable SCFE and to investigate the risk factors for AVN, specifically evaluating the notion of an "unsafe window", during which medical interventions would increase the risk for AVN. METHODS: This retrospective multicenter study included 60 patients with an unstable SCFE diagnosed between 1985 and 2014...
September 11, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27613151/treatment-for-unstable-slipped-capital-femoral-epiphysis-current-status-and-future-challenge-in-japan
#19
Takuya Otani, Tohru Futami, Atsushi Kita, Toshio Kitano, Takashi Saisu, Shinichi Satsuma, Yasuhiko Kawaguchi
BACKGROUND: Treatment for unstable slipped capital femoral epiphysis (SCFE) is challenging and controversial. For many years, the debate centered around closed treatments and especially the pros and cons of manual reduction and its concrete procedure. However, recent studies reported on open treatments such as open reduction through an anterior approach and modified Dunn procedure. Being in a period of such transition, we investigated the current status and future challenge of treatment for unstable SCFE...
November 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27603189/subcapital-shortening-osteotomy-for-severe-slipped-capital-femoral-epiphysis-preliminary-results-of-the-french-multicenter-study
#20
Brice Ilharreborde, Vincent Cunin, Saad Abu-Amara
BACKGROUND: There is growing evidence that symptomatic femoroacetabular impingement (FAI) can develop after severe slipped capital femoral epiphysis (SCFE) fixed in situ. Realignment procedures have therefore gained popularity, but complication rates remain controversial. Among them, the subcapital shortening osteotomy without hip dislocation has been progressively adopted in France, but results have never been assessed to date. METHODS: All cases performed in 23 French university hospitals between January 2010 and March 2014 were reviewed to (1) describe the surgical procedure, (2) assess the radiologic and functional outcomes, and (3) report complications and more specifically the avascular necrosis rate (AVN) according to initial stability...
September 3, 2016: Journal of Pediatric Orthopedics
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