1/113. Slipped capital femoral epiphysis after septic arthritis of the hip in an adolescent: report of a case.Septic arthritis of the hip must be managed promptly to avoid the serious complications associated with the condition. In the case reported here, the diagnosis was delayed and was complicated by a slipped capital femoral epiphysis. The patient, an adolescent boy previously in good health, presented with a 2-week history of hip pain and systemic illness. Septic arthritis was diagnosed and was managed by incision and drainage and antibiotic therapy. Two weeks later he presented with a subcutaneous abscess and a slipped capital femoral epiphysis, which was pinned in situ. There was a 2.5-cm leg-length discrepancy. Avascular necrosis of the femoral head subsequently developed leaving the boy with a permanent disability.- - - - - - - - - - ranking = 1keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
2/113. Impingement simulation of the hip in SCFE using 3D models.OBJECTIVE: Affecting as it does the geometry of adolescent hips, slipped capital femoral epiphysis (SCFE) and its evaluation represent a major three-dimensional problem. The current methods of clinical assessment-geometric measurements of the femur on plain radiographs or on axial computed tomographic (CT) cross-sections-address only one of the two joint components. MATERIALS AND methods: We have developed a system to simulate motion of hip joints with physiologic joint contact. In our system, CT-based computer models of the femur, pelvis, etc., are fitted with oriented bounding boxes (OBBs) and manipulated. Collision detection algorithms control the hip motion, which, in this virtual joint, is based on the surface geometry of the joint partners rather than on a predefined fixed rotation center. RESULTS: An illustrative case is presented to show the advantages of the new biomechanical evaluation method over conventional radiological assessments for SCFE. The proposed system provides remarkably high speed, and the necessary data can be prepared in a reasonable time. CONCLUSION: The range-of-motion assessment provides the surgeon with information about the site and the impact of nonphysiologic contact in the hip joint. The information thus obtained can be valuable for indication and planning of corrective surgery in cases of SCFE.- - - - - - - - - - ranking = 0.058886662932607keywords = femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
3/113. Slipped capital femoral epiphysis: is the displacement always posterior?The initial direction of displacement on slipped capital femoral epiphysis is generally accepted to be posterior as a consequence of retroversion of the femoral neck. We report the case of a 15-year-old boy with slipped capital femoral epiphysis in the medial direction, confirmed by three-dimensional computerized imaging. This was associated with an elongated neck without retroversion of the femoral neck. We suggest a correlation between elongated femoral neck with increased offset of the hip and the medial direction of slip. This case also underlines the need for precise definition of deformity prior to undertaking surgical treatment.- - - - - - - - - - ranking = 1keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
4/113. Arthrodiatasis for chondrolysis with hinge abduction: a case report.A 13-year-old boy with bilateral chronic slipped capital femoral epiphysis was referred to the Nagoya University Hospital. Chondrolysis occurred on the left side 3 months after a subcapital wedge osteotomy and a concavity of the femoral head appeared, which formed hinge abduction. Increase of the joint space and resolution of the hinge were achieved by arthrodiatasis. As arthrodiatasis can resolve hinge abduction by distraction and reduce mechanical stress, it may be taken into consideration as an option for diseases with hinge abduction.- - - - - - - - - - ranking = 0.17408059792311keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
5/113. Bilateral slipped upper femoral epiphysis: a rare manifestation of renal osteodystrophy. Case report with discussion of its pathogenesis.Bilateral slipped upper femoral epiphysis is a rare manifestation of renal osteodystrophy. A case of bilateral slipped femoral epiphysis in an 18-year old male suffering from chronic renal failure due to oligomeganephronic renal hypoplasia with profound signs of renal osteodystrophy is presented. serum growth hormone levels were high, while those of urinary 17-ketosteroids were decreased. Following subtotal parathyroidectomy, the progression of the process leading to slipped epiphysis was halted with closure of the epiphyses. The patient was subsequently treated with chronic hemodialysis for several months, after which successful renal transplantation was performed. The pathogenesis of renal osteodystrophy leading to slipped epiphysis is discussed and attention drawn to the fact that bilateral slipped femoral epiphysis may be the first clinical sign of chronic renal insufficiency.- - - - - - - - - - ranking = 0.39134962295396keywords = femoral epiphysis, epiphysis (Clic here for more details about this article) |
6/113. Epiphyseal separations after neonatal osteomyelitis and septic arthritis.Complete separation of an epiphysis is a rare complication of neonatal osteomyelitis and septic arthritis. We report two cases of pathologic epiphyseal separation after neonatal osteomyelitis, involving the distal and proximal femoral epiphyses with a follow-up of 2 and 7.5 years, respectively. Birth trauma, scurvy, and nonaccidental injury should be considered in the differential diagnosis of pathologic epiphyseal slip. The pitfalls in diagnosis are many, and plain radiograms of unossified epiphyses are often misleading. A high index of suspicion and the use of imaging modalities are useful in making an early diagnosis of epiphyseal slip. The optimal treatment is controversial, and the long-term prognosis is uncertain. The potential for recovery appears to be excellent, provided an early diagnosis is made and prompt treatment by anatomic reduction of the displaced epiphysis is instituted.- - - - - - - - - - ranking = 0.03104050122079keywords = epiphysis (Clic here for more details about this article) |
7/113. Apophyseal fracture of the greater trochanter.Apophyseal fractures about the pelvis and proximal femur are well-described; however, these injuries rarely involve the greater trochanter. We report the case of a 15-year-old boy of large build who appeared to have all signs and symptoms of a left slipped capital femoral epiphysis. No specific inciting event had occurred before the hip pain. Radiographs and bone scan of the capital femoral epiphysis appeared normal, and follow-up radiographs confirmed an apophyseal fracture of the greater trochanter. This case represented a rare occurrence, and its interesting manifestation was similar to that of a slipped capital femoral epiphysis.- - - - - - - - - - ranking = 0.5keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
8/113. Delayed separation of the capital femoral epiphysis after an ipsilateral transcervical fracture of the femoral neck.A displaced transcervical fracture of the femoral neck in a three-year-eight-month-old boy was fixed with two screws, which did not cross the growth plate. When he resumed walking five weeks after the injury, a delayed separation of the capital femoral epiphysis occurred. The displaced epiphysis was reduced and fixed with three unthreaded pins. In spite of disruption of the femoral neck at two sites, avascular necrosis of the femoral head did not occur. This was confirmed by two sequential isotope scans. Delayed epiphyseal separation after the femoral neck fracture and the preservation of the vascularity of the epiphysis in this case are both very unusual.- - - - - - - - - - ranking = 0.86437383455412keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
9/113. Salter-Harris type II fractures of the capital femoral epiphysis.Salter-Harris type II fractures of the capital femoral epiphysis have not been previously documented. The authors have treated three patients who sustained four such fractures. One child had a recurrent fracture two years after the first had healed satisfactorily. Two fractures were treated by spica cast immobilization, one fracture by closed reduction and internal fixation, and the other fracture healed without treatment. No patient developed avascular necrosis or other complications. Two of the children had an association with idiopathic slipped capital femoral epiphysis. An etiologic relationship with slipped capital femoral epiphysis, if any, is uncertain.- - - - - - - - - - ranking = 1.1666666666667keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
10/113. Slipped capital femoral epiphysis associated with peripheral osteoarticular tuberculosis.We report a case of slipped capital femoral epiphysis that developed associated with a peripheral osteoarticular tuberculosis lesion located at the proximal metaphysis of the femur in contact with the growth plate in a 12-year-old boy. Multiple factors have been involved in slipped capital femoral epiphysis pathogenesis, but we believe an osteoarticular tuberculosis lesion is not a common finding as a possible etiological factor causing weakness of the growth plate and, therefore, the femoral head displacement.- - - - - - - - - - ranking = 1keywords = capital femoral epiphysis, femoral epiphysis, epiphysis, capital (Clic here for more details about this article) |
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