The characteristics of the whole pelvic morphology in slipped capital femoral epiphysis

Abstract

Slipped capital femoral epiphysis (SCFE) is a very common disorder affecting the adolescent hip. The etiology of SCFE is multifactorial and mechanical force associated with the characteristic morphology of the hip is considered one of the causes of SCFE. We investigated the characteristics of whole pelvic morphology including pelvic incidence (PI) in patients with SCFE and compared it with pelvic morphology in healthy children. We retrospectively assessed the whole pelvic morphology of 17 patients with SCFE and 51 healthy children using their pelvic computed tomography data. We measured superior iliac angle, inferior iliac angle, and ischiopubic angle as the parameters of pelvic rotation. Additionally, we measured acetabular anteversion of the superior acetabulum (AVsup) and of the center of the acetabulum (AVcen), and measured anterior acetabular sector angle (AASA), posterior acetabular sector angle, and the superior acetabular sector angle (SASA) as parameters of acetabular coverage and PI. Each measurement was compared between the 2 groups. AASA and SASA of patients with SCFE were significantly greater than that of controls, and AVsup of patients with SCFE was significantly smaller. There were no significant differences in pelvic rotation, PI, or AVcen between the 2 groups. This is the 1st report to evaluate SCFE patients’ whole pelvic morphology including PI and pelvic rotation. Our results showed that patients with SCFE have excessive coverage of the anterior and superior acetabulum, and a more retroverted cranial acetabulum as compared with healthy control subjects. Such characteristic pelvic morphology may be involved in the onset of SCFE. To clarify the mechanical forces involved in SCFE onset, further investigations of pelvic morphology and alignment, including the femur and spine, are needed.

Efficacy of Single Screw Fixation for Slipped Capital Femoral Epiphysis

“…The epiphysis moves posteriorly and medially in relation to the metaphysis as a result of a weak proximal femoral physis (13) . Increased physeal obliquity, post-radiation pelvic treatment and endocrinopathy such as hypothyroidism, hypogonadism and hypopituitarism, obesity as well as increased femoral retroversion, are all implicated in the SCFE (14) .…”

The Anatomical Position of Graf’s Standard Plane and Its Relationship With Pelvic Morphology: A Computed Tomography-Based Study

“…Specifically, this method is fundamentally limited by the use of a 2D image to represent a complex 3D structure by the use of manual US probes. These characteristics may be dependent on the radiologist's experience and can result in subjective measurements of Graf's alpha and beta angles, subsequently increasing the risk of poor inter-and intra-observer agreement [3][4][5][6][7]. Several researchers have attempted to compensate for these limitations using 3D US or automatically corrected US images to evaluate DDH [12][13][14][15][16].…”

“…It is also reported that the Graf method has low inter-and intra-observer agreement because it is highly dependent on the ability of the examiner [3][4][5][6][7]. If the exact location of the standard plane in the pelvis is identified, it may contribute to improving the accuracy of the Graf method.…”

Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up

“…Simple AP and Frog leg lateral views are adequate in assessing the slip. However, in acute presentation, wherein hip abduction is not possible to obtain the frog-leg lateral view, a CT scan of the pelvis comes to the rescue [ 15 , 16 ].…”