Slipped upper femoral epiphysis (SUFE), also known as a slipped capital femoral epiphysis (SCFE), is a relatively common condition affecting the physis of the. nightstick fracture. wrist. distal radial fracture distal phalanx fracture · Jersey finger · mallet femoral. Winquist classification (femoral shaft fracture). knee. Slipped capital femoral epiphysis (SCFE) is one of the most important pediatric and adolescent hip disorders encountered in medical practice.
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SCFE is associated with a greater risk of arthritis of the hip joint later in life. Are you a health professional able to prescribe or dispense drugs?
Articles Cases Courses Quiz. 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. She has 2 years of activity-related left hip pain and pain with prolonged sitting. X-ray showing a slipped capital femoral epiphysis, before and after surgical fixation. Edit article Share article View revision history. Stress on the hip causes the epiphysis to move posteriorly and medially.
Which of the following is associated with the radiographic abnormality seen in Figure B? She has mild swelling over the ankle with no neurovascular deficit and soft compartments throughout the lower extremity.
SCFE is the most common hip disorder in adolescence. National Institute of Health. One in five cases involve both hips, resulting in pain on both sides of the body.
As the physis becomes more oblique, shear forces across the growth plate increase and result in an increased risk of fracture and resultant slippage.
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Once SCFE is dixtal, the patient should be non- weight bearing and remain on strict bed rest. Nonoperative removable walking boot vs. Subscriber If you already have your login data, please click here.
Retrieved 1 December Pediatric Orthopaedic Society of North America. October Pages The diagnosis is a combination of clinical suspicion plus radiological investigation. Obesity is a significant risk factor. Show more Show less.
Case 15 Case The fracture occurs at the hypertrophic zone of the physeal cartilage. Her radiographs are shown epifisiopisis Figures A and B. Nelson textbook of pediatrics 19th ed. Is the closed reduction acceptable? Ultrasound may be performed in the assessment of hip pain. Running, and other strenuous activity on legs, will also cause the hips to abnormally move due to the condition and can potentially worsen the pain.
SCFEs usually cause groin pain on the affected side, but sometimes cause knee or thigh pain. Views Read Edit View history. This is followed by the acute slip which is posteromedial. Skeletal changes may also make someone at risk of Epifisioliiss, including femoral or acetabular retroversion,  those these may simply be chronic skeletal manifestations of childhood obesity.
Physical examination reveals external rotation of the extremity with hip flexion. Because the epiphysis moves posteriorly, it appears smaller because of projectional factors.
Slipped Capital Femoral Epiphysis (SCFE)
While distzl has a role in the manifestation of the fracture, an intrinsic weakness in the physeal cartilage also is present. HPI – Twisting injury 4 hours ago No prior pain or history of trauma. From Monday to Friday from 9 a. MRI can be used to examine the contralateral hip which is important because of epirisiolisis high incidence of bilateral slip.
Lizaur UtrillaE. A reduction maneuver is attempted under conscious sedation but fluoroscopic images are unchanged. Usually, a SCFE causes groin pain, but it may cause pain in only the thigh or knee, because the pain may be referred along the distribution of the obturator nerve. SCFE affects approximately 1—10 perchildren. A small incision is made in the outer side of the dishal thigh and metal pins are placed through the femoral neck and into the head of the femur.
Slipped upper femoral epiphysis | Radiology Reference Article |
Core Tested Community All. Retrieved from ” https: Whilst it can occur in any child, the major risk factor is childhood obesity. This video briefly explain the etiologic factors that causes hip pain in child. Which of the following figures accurately represents the method used to determine the radiographic severity of the epiphyseal slip and help guide treatment? Pediatric Orthopaedic Society of North America.
ORIF reduction percutaneous manipulation with K wires may aid reduction open reduction may be required if interposed tissue present instrumentation transepiphyseal fixation best if at all possible cannulated screws parallel to physis Tillaux and triplane epifisoolisis 2 parallel epiphyseal screws medial malleolus shear fractures transphyseal fixation smooth K wires.
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Alignment of the epiphysis with respect to the femoral metaphysis can be used to grade the degree of slippage: