Shape of growth plate of proximal femur in children and its significance in the aetiology of slipped capital femoral epiphysis

Abstract

PurposeThe main objective of the study was to present the influence of the morphological shape of the proximal femoral growth plate in children as one of the risk factors for the incidence of slipped capital femoral epiphysis (SCFE) in adolescents.MethodsThis research is based on the X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) data obtained for 100 children three to 13 years old, all treated at the Children’s Orthopaedic Clinic and Rehabilitation Department and Department of Radiology Medical University of Lublin between 2005 and 2009. We took into account 83 children with healthy hip joints and 17 children with SCFE. We also performed morphological analysis of the shape of the proximal femoral growth plate together with X-ray, CT and MRI examinations of the proximal ends of cadaver femurs for two children aged six and 13.ResultsIn the final findings we present an analysis of the shape of the proximal femoral growth plate in children between the third and 13th years of life and consider a correlation between the shape of the proximal femoral growth plate and its influence on the incidence of SCFE in adolescents.ConclusionsThe change of shape of the proximal femoral growth plate from pleated to more spherical is one of the risk factors for the incidence of SCFE in children ten years old and older.

Remodelling of femoral head–neck junction in slipped capital femoral epiphysis: a multicentre study

“…Our results offer insight into decision making for in situ pinning or adapting corrective osteotomies in cases of poor remodelling. Additionally, Kandzierski et al reported that a growth plate finally reaches a shape of a convex meniscus and that minor ruggedness of its surface gradually disappears at the age of 11-13 years [22]. These growth-plate changes might indicate poor remodelling ability after the age of 11 years.…”

Subclinical bilateral involvement of the hip in patients with slipped capital femoral epiphysis—a multicentre study

“…Our results showed a significant difference in the contralateral PSA between the SCFE and control groups, and 70 % of contralateral hips in the SCFE group had increased posterior inclination compared to the mean PSA + 2SD in the control group. These morphological changes might contribute to future impingement and degenerative joint disease [24][25][26].…”

Geometrical and mechanical factors that influence slipped capital femoral epiphysis

“…Observations made by Kandzierski et al [14] show that the growth plate of a 13-year-old child has a form of a part of a sphere. This means that curvature exists in both coronal and sagittal planes.…”

“…This means that curvature exists in both coronal and sagittal planes. However, for an 11-year-old child, physeal morphology resembles a meniscus; that is, it has the shape of a curved disc [14]. Therefore, physeal curvature in all cases was modeled only in the coronal plane.…”

“…This structure was modeled as the cut of two parallel, curved, and inclined planes through the femoral head [10,14]. The separation of the planes defines physeal thickness, whereas their slope corresponds to the angle formed by the diaphyseal axis (blue line in Fig.…”