&lt;p&gt;Slipped capital femoral epiphysis: current management strategies&lt;/p&gt;

Aprato, Alessandro; Conti, Andrea A.; Bertolo, Federico; Massè, Alessandro

doi:10.2147/orr.s166735

Cited by 35 publications

(50 citation statements)

References 66 publications

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“…Desde el punto de vista clínico la efp puede clasificarse en función del tiempo de evolución, siendo crónica si persiste por más de tres semanas, aguda si dura menos de tres semanas y crónica reagudizada si los síntomas ocurren abruptamente con exacerbación del dolor e incapacidad para caminar, durante más de tres semanas. La variante crónica representa la mayoría de los casos en un 85 % (4,19).…”

Section: Clasificaciónunclassified

“…La clasificación descrita por Loder (20) es más útil y está determinada por los síntomas del paciente, específicamente por la tolerancia a la marcha, lo que establece de manera indirecta la estabilidad de la fisis; son estables el 90 % (el paciente puede caminar) e inestables el resto (el paciente no puede caminar); dicha clasificación es práctica debido a que las estables son de mejor pronóstico comparadas con las inestables, que son de peor pronóstico y con mayor tasa de complicaciones (1,2,15,19).…”

Section: Clasificaciónunclassified

“…La incidencia actual de efp varía de 0,33 en 100.000 a 24,58 en 100.000 niños de ocho a quince años de edad, dependiendo del sexo y el origen étnico (19). Lehmann reportó una incidencia de efp en Estados Unidos para niños de nueve y dieciséis años, de 10,80 casos / 100.000 niños (3), Perry reportó una incidencia de efp en Reino Unido para niños de cero y dieciséis años de 4,8 casos / 100.000 niños (11).…”

Section: Epidemiologíaunclassified

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Epifisiólisis femoral proximal, una entidad desapercibida en atención primaria

Bateca

2020

Rev. Med.

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La epifisiólisis femoral proximal o deslizamiento capital femoral es un trastorno de la cadera que se caracteriza por un desplazamiento de la epífisis sobre la metáfisis a través de la fisis (cartílago de crecimiento), quedando la epífisis posterior e inferior. Es una entidad relativamente frecuente en atención primaria y prehospitalaria que genera dolor y limitación de cadera; sin embargo, por su sintomatología vaga es usualmente infradiagnosticada o es diagnosticada tardíamente generando consecuencias a largo plazo. Si se tienen en cuenta los factores de riesgo asociados a una adecuada exploración física y el uso imágenes diagnósticas se lograría hacer un diagnóstico oportuno y una disminución de la tasa de complicaciones.

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Section: Clasificaciónunclassified

Section: Epidemiologíaunclassified

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Epifisiólisis femoral proximal, una entidad desapercibida en atención primaria

Bateca

2020

Rev. Med.

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“…Slipped Capital Femoral Epiphysis (SCFE) is considered the most common hip disorder affecting adolescents. [1][2][3][4] It is a Salter-Harris type I fracture characterized by slippage through the hypertrophic zone of the upper femoral epiphysis in a backward direction. [5][6][7][8] The aetiology remains controversial but generally multifactorial in origin; implicating genetic, constitutional and endocrine factors.…”

Section: Introductionmentioning

confidence: 99%

Total hip arthroplasty in patients with slipped capital femoral epiphysis: a systematic analysis of 915 cases

Kenanidis¹,

Kakoulidis²,

Panagiotidou³

et al. 2021

Orthop Rev (Pavia)

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There is limited evidence on the outcomes of Total Hip Arthroplasty (THA) in Slipped Capital Femoral Epiphysis (SCFE) patients. This systematic review aims to evaluate the current literature in terms of survival rate, functional outcomes, complications and types of implants of THA in SCFE patients. Following the established methodology of PRISMA guidelines, PubMed, Cochrane library, ScienceDirect and Ovid MEDLINE were systematically searched from inception to September 2018. The search criteria used were: (“total hip arthroplasty’’ OR ‘’total hip replacement’’ OR “hip arthroplasty’’ OR ‘’hip replacement’’) AND (‘’slipped capital femoral epiphysis’’ OR ‘’slipped upper femoral epiphysis’’ OR ‘’femoral epiphysis’’). Ten studies were finally included in the analysis and were qualitatively appraised using the Newcastle-Ottawa tool. Variables were reported differently between studies. The sample size varied from 12 to 374 THAs. A total of 877 patients undergone 915 THAs. The mean reported follow-up ranged from 4.4 to 15.2 years and the mean patients’ age at the time of THA from 26 to 50 years. Four studies specified the type of implants used, with 62% being uncemented, 24% hybrid (uncemented cup/cemented stem) and 14% cemented. All but three studies reported the mean survival of implants that ranged from 64.9% to 94.8%. A limited number of complications were mentioned. There was a tendency for more favorable functional outcomes in modern studies. Modern THA-studies in SCFE patients showed improvement of survivorship, clinical outcomes and patient satisfaction. Future higher-quality studies are necessary to estimate long-term postoperative outcomes better.

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“…We are aware of no previous study in which the angle of epiphyseal obliquity and its precise spatial orientation based on 2 radiographs perpendicular to each other have been calculated. This uncertainty may be a reason why a consensus is missing concerning the best treatment for SCFE 45 .…”

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confidence: 99%

Epiphyseal Angulation and Related Spatial Orientation in Slipped Capital Femoral Epiphysis

Gautier

Passaplan

Gautier³

2020

JBJS Open Access

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Background: The management of slipped capital femoral epiphysis (SCFE) is controversial. Surgical decision-making is based regularly on the chronicity, stability, and severity of the slip. The purpose of this study was to determine the true angulation and spatial orientation of the epiphysis in hips with SCFE and contralateral hips. Methods: Eighteen hips in 18 patients with SCFE were included in the analysis. Trigonometric calculations, based on angle measurements using 2 conventional radiographs in planes that are perpendicular to each other, were used to determine the angulation of the epiphysis and its orientation in space. Results: The mean absolute epiphyseal obliquity of the SCFE hips was 56.2° and the spatial orientation was 36.5°. The mean obliquity of the contralateral side was 34.0°, with a related spatial orientation of 16.8°. The maximum error can reach up to 9.9° (or 41%) when comparing the calculated angles with the angle measurements on radiographs. Conclusions: On standard radiographs, the epiphyseal angulation in SCFE is consistently underestimated. As a consequence, the assigned classification of some patients may be 1 severity group too low, which impacts the value of traditional severity classification for surgical decision-making. The analysis of the spatial orientation of the slip with the concomitant direction of the resultant shear can partially explain varus and valgus slip in SCFE. Level of Evidence: Diagnostic Level IV . See Instructions for Authors for a complete description of levels of evidence.

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<p>Slipped capital femoral epiphysis: current management strategies</p>

Cited by 35 publications

References 66 publications

Epifisiólisis femoral proximal, una entidad desapercibida en atención primaria

Epifisiólisis femoral proximal, una entidad desapercibida en atención primaria

Total hip arthroplasty in patients with slipped capital femoral epiphysis: a systematic analysis of 915 cases

Epiphyseal Angulation and Related Spatial Orientation in Slipped Capital Femoral Epiphysis

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