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https://www.readbyqxmd.com/read/28632591/acetabular-retroversion-but-not-increased-acetabular-depth-or-coverage-in-slipped-capital-femoral-epiphysis-a-matched-cohort-study
#1
Tobias Hesper, Sarah D Bixby, Young-Jo Kim, Yi-Meng Yen, Garrett Bowen, Patricia Miller, Michael B Millis, Eduardo N Novais
BACKGROUND: Femoral head overcoverage by a deep and retroverted acetabulum has been postulated as a mechanical factor in slipped capital femoral epiphysis (SCFE). We assessed acetabular depth, coverage, and version in the hips of patients with unilateral SCFE; in the contralateral, uninvolved hips; and in healthy control hips. METHODS: Thirty-six patients affected by unilateral SCFE were matched to 36 controls on the basis of sex and age. The acetabular depth-width ratio (ADR), the lateral center-edge angle (LCEA), the anterior and posterior acetabular sector angle (ASA), and version (10 mm distal to the highest point of the acetabular dome and at the level of the femoral head center) were assessed on computed tomography (CT)...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28529665/slipped-capital-femoral-epiphysis-a-spectrum-of-surgical-care-and-changes-over-time
#2
R T Loder
PURPOSE: To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. METHODS: Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529664/patient-specific-3d-models-aid-planning-for-triplane-proximal-femoral-osteotomy-in-slipped-capital-femoral-epiphysis
#3
L Cherkasskiy, J P Caffrey, A F Szewczyk, E Cory, J D Bomar, C L Farnsworth, M Jeffords, D R Wenger, R L Sah, V V Upasani
PURPOSE: Slipped capital femoral epiphysis (SCFE) can result in a complex three-dimensional (3D) deformity of the proximal femur. A three-plane proximal femoral osteotomy (TPFO) has been described to improve hip mechanics. The purpose of this study was to evaluate the benefits of using 3D print technology to aid in surgical planning. PATIENTS AND METHODS: Fifteen children treated with TPFO for symptomatic proximal femoral deformity due to SCFE were included in this study...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#4
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529661/slipped-capital-femoral-epiphysis-management-and-the-arthroscope
#5
F Accadbled, O May, C Thévenin-Lemoine, J Sales de Gauzy
BACKGROUND: In situ pinning of slipped capital femoral epiphysis (SCFE) results in various degrees of deformity of the femoral head-neck junction. Repetitive trauma from cam-type femoroacetabular impingement (FAI) can lead to labral tears and injury to the articular cartilage causing loss of function. Arthroscopic osteoplasty is an alternative to open procedure and to Southwick/Imhäuser-type osteotomies in symptomatic selected cases. SURGICAL TECHNIQUE: The amount of bone to be resected has to be carefully planned pre-operatively...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529660/biomechanical-considerations-in-slipped-capital-femoral-epiphysis-and-insights-into-prophylactic-fixation
#6
E Leblanc, J M Bellemore, T Cheng, D G Little, O Birke
PURPOSE: Slipped capital femoral epiphysis (SCFE) is a deformity of the proximal femur secondary to widened and unstable physis. In stabilising the slip, gold standard treatments stop growth and involve premature physeal closure, which prevents the remodelling of the acquired deformity and creates a leg length discrepancy that may be significant in younger patients. METHODS: We measured the impact of placing threaded screws across the proximal femoral physis by measuring the centre-trochanteric distance (CTD) and articulo-trochanteric distance (ATD) in participants with or without prophylactic fixation...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529659/prognostic-factors-for-long-term-outcome-of-chronic-slipped-capital-femoral-epiphysis-treated-with-fixation-in-situ
#7
T Terjesen, A Wensaas
PURPOSE: Predictive factors for long-term outcome after in situ fixation for chronic slipped capital femoral epiphysis (SCFE) have so far not been systematically analysed. The aims of this study were to define predictors for long-term outcome and to assess the association between initial grade of slipping and post-slip deformities. METHODS: We studied 51 patients (60 hips) with chronic SCFE treated with in situ fixation. There were 31 males and 20 females with a mean age of 12...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529658/pinning-the-slipped-and-contralateral-hips-in-the-treatment-of-slipped-capital-femoral-epiphysis
#8
G Hägglund
PURPOSE: To describe and comment on the treatment of the slipped capital femoral epiphysis (SCFE) with pinning and to present the pros and cons of prophylactic pinning of the contralateral hip. SUMMARY: Pinning the SCFE aims to fix the epiphysis and prevent further slipping. Some devices allow for further growth and remodeling of the femoral neck post-operatively. This results in maintained femoral offset and probably reduced risk of femoroacetabular impingement...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529657/in-situ-pinning-in-slipped-capital-femoral-epiphysis-long-term-follow-up-studies
#9
F Accadbled, J Murgier, B Delannes, J P Cahuzac, J Sales de Gauzy
BACKGROUND: Management of moderately displaced slipped capital femoral epiphysis (SCFE) is debated, mostly because of the risks related to open reduction on one hand, and subsequent evolution toward femoroacetabular impingement (FAI) on the other. METHOD: All SCFE cases treated with in situ fixation (ISF) and a minimum of ten years of follow-up beyond skeletal maturity were analysed in a retrospective multicentre study. Coxometry parameters were measured. Long-term results of ISF were meanwhile analysed at our Institution...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529656/imaging-modalities-in-patients-with-slipped-capital-femoral-epiphysis
#10
T Hesper, C Zilkens, B Bittersohl, R Krauspe
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is a frequent disorder of the adolescent hip, which may lead to avascular necrosis (AVN) of the femoral head, chondrolysis and early osteoarthritis due to the post-slip deformity of the proximal femur. To warrant the best possible outcome for the affected (and contralateral) hip, early diagnosis and proper treatment are needed. METHODS: A review of the literature was undertaken to identify today's role of available imaging modalities in the management of SCFE...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529655/scfe-clinical-aspects-diagnosis-and-classification
#11
M B Millis
PURPOSE: This article seeks to improve treatment outcomes in slipped capital femoral epiphysis (SCFE) by outlining advances in diagnosis, understanding of pathomechanics, and mechanically-based classification. METHODS: Review of clinical experience with SCFE at our high-volume centre, interaction with other clinical experts, and literature review has allowed a current perspective to be articulated. RESULTS: SCFE remains an important clinical problem, with late diagnosis still frequent...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529654/histological-histochemical-and-ultrastructural-study-of-slipped-capital-femoral-epiphysis
#12
I Tresoldi, A Modesti, M Dragoni, V Potenza, E Ippolito
PURPOSE: The purpose of our study was to investigate the histological, histochemical and ultrastructural aspects of the proximal femoral growth plate in slipped capital femoral epiphysis (SCFE). METHODS: Eight core biopsies of the proximal femoral growth plate were performed during in situ epiphysiodesis in patients with SCFE that was at the pre-slipping stage in two cases and at the mild slipping stage (Southwick angle < 30°) in six cases. After fixation, the specimens were processed for either histological or histochemical or ultrastructural studies...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529653/special-symposium-issue-slipped-capital-femoral-epiphysis-scfe
#13
EDITORIAL
R Krauspe, S Weinstein
Up-date on the pathogenesis, epidemiology, pathology, histopathology, clinical findings, diagnosis & classification, imaging modalities and all treatment options in slipped capital femoral epiphysis. This symposium issue of JCO is based on lectures presented at the Pre-Course at the 35th Annual Congress of the European Paediatric Orthopaedic Society (EPOS) in 2016.
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28513428/slipped-capital-femoral-epiphysis-a-review-of-management-in-the-hip-impingement-era
#14
Mahmoud A Mahran, Mostafa M Baraka, Hany M Hefny
Slipped capital femoral epiphysis (SCFE) remains the most common adolescent hip disorder. Most cases present with stable slips, and in situ fixation is the most commonly adopted treatment worldwide. The introduction of the concept of femoroacetabular impingement and subsequent studies have revealed SCFE-related hip impingement to be a significant pre-arthritic condition, and the previously suggested remodeling of the proximal femur after in situ fixation has been called into question. Complex proximal femoral osteotomies and more recently intra-articular procedures via surgical hip dislocation have been employed...
2017: SICOT-J
https://www.readbyqxmd.com/read/28509827/leptin-elevation-as-a-risk-factor-for-slipped-capital-femoral-epiphysis-independent-of-obesity-status
#15
Schuyler J Halverson, Tracy Warhoover, Gregory A Mencio, Steven A Lovejoy, Jeffrey E Martus, Jonathan G Schoenecker
BACKGROUND: Slipped capital femoral epiphysis (SCFE) is strongly associated with childhood obesity, yet the prevalence of obesity is orders of magnitude greater than the prevalence of SCFE. Therefore, it is hypothesized that obesity is not, by itself, a sufficient condition for SCFE, but rather one component of a multifactorial process requiring preexisting physeal pathology. Leptin elevation is seen to varying degrees in patients with obesity, and as leptin has been shown to cause physeal pathology similar to the changes seen in SCFE, we propose that leptin may be a factor distinguishing between patients with SCFE and equally obese children without hip abnormalities...
May 17, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28489740/percutaneous-pinning-after-prolonged-skeletal-traction-with-the-hip-in-a-flexed-position-for-unstable-slipped-capital-femoral-epiphysis-a-case-series-of-11-patients
#16
Masaki Matsushita, Kenichi Mishima, Kohji Iwata, Tadashi Hattori, Naoki Ishiguro, Hiroshi Kitoh
BACKGROUND: Unstable slipped capital femoral epiphysis (SCFE) has a relatively high risk of avascular necrosis of the femoral head. Standard treatment for unstable SCFE is still controversial. We reviewed unstable SCFE case series treated with the standardized protocol, which consisted of percutaneous pinning after prolonged skeletal traction. METHODS: Our treatment regimen for unstable SCFE patients included 1 week or more of skeletal traction with the hip in a flexed position of 45 degrees, and subsequent percutaneous pinning after unintentional reduction...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28455719/valgus-slipped-capital-femoral-epiphysis-with-contralateral-pre-slip
#17
Dana E Amiraian, Zahir Sarwar, William R Bireley, Elizabeth Moran
Slipped capital femoral epiphysis (SCFE) is a common hip disorder in older children and adolescents, classically with medial and posterior slippage of the proximal femoral epiphysis. However, valgus SCFE is a very rare entity, where the proximal femoral epiphysis slips laterally and posteriorly. To our knowledge, valgus SCFE with magnetic resonance imaging (MRI) features of contralateral pre-slip has not yet been reported. We present a case of a 9 year old girl with symptomatic valgus SCFE on the left and asymptomatic contralateral pre-slip on the right with concurrent radiographic, sonographic, and MRI findings...
April 28, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28439307/fluoroscopic-imaging-overestimates-the-screw-tip-to-subchondral-bone-distance-in-a-cadaveric-model-of-slipped-capital-femoral-epiphysis
#18
M J Heffernan, B Snyder, H Zhou, X Li
PURPOSE: Intra-operative imaging plays a key role in screw placement for slipped capital femoral epiphysis (SCFE). Complications have been associated with inadequate screw position. The purpose of this study was to evaluate computed tomography (CT) (3D fluoroscopy) and standard fluoroscopy (C-arm) images as compared with direct anatomic measurement to determine final screw position in a cadaveric SCFE model. METHODS: Osteotomy with pinning was performed at the physeal scar in ten cadaveric hips...
2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28382187/ultrasonographic-diagnosis-of-slipped-capital-femoral-epiphysis
#19
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
#20
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
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