Epifisiolistesis femoral proximal. AV. Alvaro Valdez. Updated 6 August Transcript. ingle, muslo, rodilla. sordo, vago, intermitente o continuo. > actividad. Epifisiolistesis femoral proximal. Experiencia en el tratamiento con tornillo canulado. Rev Mex Ortop Ped ; 1 (1). Language: Español References: Slipped capital femoral epiphysis (SCFE) is one of the most important pediatric and adolescent hip disorders encountered in medical practice.
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Archives of Disease in Childhood.
Slipped Capital Femoral Epiphysis (SCFE)
X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. The hip is a ball-and-socket joint, which means that the rounded end of one bone in this case, the “ball” of the thighbone fits into the hollow of another bone the pelvis.
It is actually the metaphysis neck part of a bone which slips in an anterior direction with external rotation. Physical examination reveals external rotation of the extremity with hip flexion. Retrieved from ” https: Failure to treat a SCFE may lead to: Most teens whose SCFE is caught and treated early do well.
In this case, pain begins in the affected hip joint but is felt in the normal knee joint. Stress around the hip causes a shear force to be applied at the growth plate. Flexion, internal rotation, and valgus-producing epicisiolistese femoral osteotomy Imhauser osteotomy. Though the name’s quite a mouthful, it simply refers to a shift at the upper part of the thighbone, or femur, that results in a weakened hip joint.
Associated with decreased femoral anteversion and decreased femoral neck-shaft angle. Surgical intervention was postponed until normalization of thyroid function, anemia, and metabolic profile.
Because of his obesity, he was then referrer to the Nutrition and to the Endocrinology Services of Hospital de Pediatria Garrahan. How important is this topic for clinical practice? At 12 year, 11 months of age, after a diagnosis of bilateral slipped capital femoral epiphysis was made. Outpatient control recommendation was indicated. L6 – years in practice. Normally, the head of the femurcalled the capital, should sit squarely epifisoolistese the femoral neck.
Often the range of motion in the hip is restricted in internal rotationabductionand flexion. An unstable SCFE is very serious because it can restrict blood flow to the hip joint.
Arch Biochem Biophys ; The job of the physis is to connect the femoral head the “ball” to the femur while epifisiolustese allowing the bone to lengthen and grow. SCFE is also more likely to happen to teens who have specific stuff going on with their health, such as:. Thank you for rating!
Slipped capital femoral epiphysis – Wikipedia
From Wikipedia, the free encyclopedia. On physical examination she has restricted hip flexion motion, an external rotation deformity, and obligatory external rotation upon hip flexion manuevering. Because the physis has yet to close, the blood supply to the epiphysis still should be derived from the femoral neck; however, this late in childhood, the supply is tenuous and frequently lost after the fracture occurs. epifisiplistese
In rare cases, the X-rays will come back normal, but the pain, stiffness, and other problems will still be there. Current opinion in pediatrics ; 8: He also had normal serum ACTH, as well as pre-pubertal serum gonadotropins and testosterone, compatible with the clinical findings. Because some patients have epifjsiolistese high risk of an SCFE in the other hip, the surgeon might also stabilize that side too, even if it hasn’t slipped yet. Symptoms that persist for less than 3 weeks.
Clin Orthop ; She is not dependent on crutches for ambulation. Open reduction and pinning with multiple cannulated screws in an inverted triangle configuration.
The left hip is more often affected than the right.
Deslizamiento de la epífisis capital femoral (SCFE, o epifisiolisis)
SCFEs usually cause groin pain on the affected side, but sometimes cause knee or thigh pain. SCFEs are most common in adolescents 11—15 years of age,  and affects boys more frequently than girls male 2: Maintaining a healthy weight can go a long way in sparing your bones and joints from the excess wear and tear that can weaken and damage them. Manipulation of the fracture frequently results in osteonecrosis and the acute loss of articular cartilage chondrolysis because of the tenuous nature of the blood supply.
Sometimes SCFE can irritate the nerves that epifisiolistees down the leg so the person thinks the pain is coming from the knee.
Slipped Capital Femoral Epiphysis (SCFE) – Pediatrics – Orthobullets
A review of the literature with two classic case examples. A stable SCFE usually causes the person to limp and walk with the foot turned outward.
The fracture occurs at the hypertrophic zone of the physeal cartilage. Almost all cases require surgery, which usually involves the placement of one or two pins into the femoral head to prevent further slippage. Doctors decide how much weight can be placed on the affected leg after surgery based on the severity of the slip.
Heyerman W, Weiner D. Frequent falls due to crossed legs. American Academy of Orthopaedic Surgeons. More on this topic for: The diagnosis is a combination of clinical suspicion plus radiological investigation.