Slipped Capital Femoral Epiphysis

Georgiadis, Andrew; Zaltz, Ira

doi:10.1016/j.pcl.2014.08.001

Cited by 55 publications

(62 citation statements)

References 77 publications

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“…Since the perichondral ring is thin, the wide surface area of the undulating, interlocking mammillary processes guarantee most of the internal support of the normal physis. On the other hand, SCFE is characterized by physeal widening (as much as 12 mm, with normal range 2–6 mm), a widened hypertrophic zone comprising 60%–80% of physeal height, enlargement of chondrocytes, cellular column disorganization, higher proteo-glycan and extracellular matrix concentrations in the physis, and widespread disruption in chondrocyte differentiation and endochondral ossification 8. Radiographic physeal widening underlines a mechanically weakening of the physis that is susceptible to unlocking mammillary processes, resulting in further destabilization.…”

Section: Etiology and Histopathologymentioning

confidence: 99%

“…Anatomically, it always stands below the foramina for the lateral epiphyseal vessels, and is postulated to confer mechanical strength to the physeal plate. For this reason, it is theorized to be crucial for physeal stability, but it decreases in size and surface area during childhood and adolescence as peripheral physeal cupping increases 8. Liu et al9 postulated that the epiphysis rotates internally on the epiphyseal tubercle and that a widened physis could contribute to epiphyseal dislodgement.…”

Section: Etiology and Histopathologymentioning

confidence: 99%

“…AVN has been reported after surgical dislocation with pinning in situ, and its rate has been estimated up to 47% in unstable slips 8. In fact, according to Loder’s classification system, it is assumed that none of the stable hips developed AVN,19 but most recent reports have discussed the incidence of that only in unstable SCFE.…”

Section: Treatmentmentioning

confidence: 99%

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

Aprato

Conti²,

Bertolo³

et al. 2019

ORR

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In orthopedic literature, there is little consensus regarding the best management of slipped capital femoral epiphysis (SCFE). Controversies and disparate trends derive from differences in clinical presentation, various classifications, and a variety of surgical procedures that have been described. Currently, there are no evidence-based recommendations. Surgical procedures vary, and they can be divided into fixation in situ, compensatory osteotomies, and direct corrections of the deformity at the head–neck junction. The first and second group of procedures have so far not gained optimal control over the risk of avascular necrosis or cannot achieve an anatomically aligned epiphysis with normal blood supply. On the other hand, the third technique can achieve this target and prevent residual deformity and the development of early hip arthritis, but it is not widely accepted, because of its surgical complexity. The purpose of this work is to present an overview of current knowledge and provide an orientation on clinical and surgical management of the patient suffering from SCFE.

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Section: Etiology and Histopathologymentioning

confidence: 99%

Section: Etiology and Histopathologymentioning

confidence: 99%

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

Aprato

Conti²,

Bertolo³

et al. 2019

ORR

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“…Slipped upper femoral epiphysis (SUFE) is an important adolescent hip disorder encountered in orthopaedic surgical practice. 1 2 SUFE can be categorised as a Salter-Harris type fracture, 3 characterised by the slippage of the proximal femoral metaphysis anteriorly and superiorly relative to the epiphysis. 4 The epiphysial plate is usually widened due to the presence of an unusually large hypertrophic zone.…”

Section: Introductionmentioning

confidence: 99%

SUFE and the internet: are healthcare information websites accessible to parents?

Carthy

Taylor

2020

bmjpo

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BackgroundSlipped upper femoral epiphysis is an adolescent hip disorder requiring rapid surgical intervention. Faced with the prospect of their child undergoing surgery, many fearful parents will turn to the internet to provide information and reassurance. Previous studies have shown the orthopaedic information can be difficult to comprehend.ObjectiveAssess the readability of healthcare websites regarding slipped upper femoral epiphysis.MethodsThe term Slipped Upper Femoral Epiphysis was searched in Google, Bing and Yahoo. The websites were evaluated using readability software with seven specialised readability tests including the Flesch-Kincaid Reading Grade Level, the Flesch Reading Ease Score, the Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index and the Gunning Fog Index. The reading grade level (RGL) was also calculated.A Flesich Read Ease Score (FRES) score above 65 and an RGL of sixth grade and under was considered acceptable. Websites were also assessed for translation services.Results21 unique websites were assessed. The average FRES was 52.5±15.4. Only 3 websites scored 65 or higher (14%). There was a statistically significant difference between website scores based on affiliation, with physician websites having the overall highest mean(p=0.004).The average RGL was 8.67±1.8. Only two websites met the accepted RGL criteria (9.5%) while five websites were marked as extremely difficult to understand (23.8%). Only five websites offered translations (23.8%). There was no statistically significant difference in readability scores between websites which offered translation and those which did not.One-sample t-tests showed that both the RGL (p<0.001; CI 1.83 to 3.49) and the FRES (p<0.001, CI −19.4 to −5.4) scores were significantly different from the accepted standard.ConclusionMost websites reviewed were above the recommended RGL, making content inaccessible. Improving readability and translation services would enhance the internet’s usability as a healthcare tool for parents.

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“…[ 6 ] A high index of suspicion is needed to diagnose this condition in adolescents and young adults when they present with hip pain and a limping gait. [ 7 ] Most of these patients require endocrine assessment to rule out hormonal deficiencies. [ 1 ]…”

Section: Discussionmentioning

confidence: 99%

An uncommon cause for hip pain and limping

Shetty

Sathyakumar

Kapoor

et al. 2015

J Family Med Prim Care

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Slipped capital femoral epiphysis (SCFE) is characterized by displacement of the capital femoral epiphysis from the femoral neck. An 18-year-old male presented with left hip pain and a limping gait, following a trivial trauma. Radiological examination revealed bilateral SCFE. Clinically and biochemically, he had features of hypopituitarism. His prolactin levels were high and magnetic resonance imaging (MRI) scan showed a pituitary macroadenoma, suggesting a diagnosis of macroprolactinoma causing hypopituitarism and presenting as SCFE. He was started on dopamine agonist cabergoline as well as thyroxine and glucocorticoid replacement treatment. He was also scheduled for an orthopedic surgical procedure for his SCFE.

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Slipped Capital Femoral Epiphysis

Cited by 55 publications

References 77 publications

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

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

SUFE and the internet: are healthcare information websites accessible to parents?

An uncommon cause for hip pain and limping

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