Acute slipped capital femoral epiphysis

Loder, Randall T.; Richards, B. Stephens; Shapiro, Paul; Reznick, L R; Aronson, David D.

doi:10.2106/00004623-199308000-00002

Cited by 543 publications

(125 citation statements)

References 16 publications

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“…We used the clinical classification according to Loder [49] for the stability of the capital physis because this did not require any new preoperative diagnostic methods to be implemented. When this study was initiated in 2007 this classification was widely accepted [37, 42, 63–67] but there are reports that argue against this classification because even within this group the degree of stability of the physis has been shown to vary [41, 68–72].…”

Section: Discussionmentioning

confidence: 99%

“…For both these methods a minimum slip angle of 13 ° was required for diagnosis [12, 46, 48]. If no lateral view was obtained, because of an unstable SCFE [49] , the Southwick head-shaft angle HSA [50] on the anteroposterior (AP) view was used. There is no cut off value described for SCFE in the literature using the HSA in the AP view.…”

Section: Methodsmentioning

confidence: 99%

“…The clinical classification described by Loder et al [49] was used where the SCFE was either stable or unstable (not being able to ambulate with two crutches). Information from the medical records on admission to the hospital or from the description of the surgical procedure performed was used for the clinical classification.…”

Section: Methodsmentioning

confidence: 99%

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Slipped capital femoral epiphysis: a population-based study

Herngren

Stenmarker

Vavruch

et al. 2017

BMC Musculoskelet Disord

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BackgroundSlipped capital femoral epiphysis (SCFE) is the most common hip disorder in children 9–15 years old. This is a population-based study in Sweden presenting the epidemiology for SCFE.MethodsIn a prospective cohort study, we analysed pre- and postoperative radiographs, medical records for all children treated for SCFE in Sweden 2007–2013, demographic data, severity of slip and surgical procedures performed.ResultsWe identified 379 Swedish children with primary SCFE 2007–2013; 162 girls, median age 11.7 (7.2–15.4) years, and 217 boys, median age 13 (3.8–17.7) years. The average annual incidence was 4.4/10000 for girls and 5.7/10000 for boys 9–15 years old. Obesity or overweight was found in 56% of the girls and in 76% of the boys. As an initial symptom, 66% of the children had hip/groin pain and 12% knee pain. At first presentation, 7% of the children had bilateral SCFE. Prophylactic fixation was performed in 43%. Of the remaining children, 21% later developed a contralateral slip.Fixation with implants permitting further growth was used in >90% of the children. Femoral neck osteotomy was performed for 11 hips.ConclusionsThe annual average incidence 2007–2013 in Sweden showed a mild increase for girls. The male-to-female ratio was lower than previous regional data from Sweden. Overweight or obesity is one major characteristic for boys with SCFE but to a less extent for girls. Knee pain as initial symptom cause a delay in diagnosis. Most hospitals in Sweden treat <2 children annually.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Slipped capital femoral epiphysis: a population-based study

Herngren

Stenmarker

Vavruch

et al. 2017

BMC Musculoskelet Disord

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“…Loder, et al (9) reported that the single most important factor for the stability of physis was whether the slip was stable or unstable. Hagiwara, et al (10) also demonstrated that the insertion of the screw in the proximal aspect had great significance for stability.…”

Section: Discussionmentioning

confidence: 99%

Does the number of engaged screw threads affect the stability of slipped capital femoral epiphysis insitu fixation?

Günay¹,

Küçük²,

Sözbilen³

et al. 2017

BUCH

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Objective: The management of slipped capital femoral epiphysis (SCFE) frequently seen in obese adolescents is fixation with cannulated screw. In this study, it was aimed to evaluate the relationship between the stability of the physis and the number of screw threads passing across the physeal line in the treatment of slipped capital femoral epiphysis (SCFE) with single screw fixation. Methods: Thirty-three hips of 25 SCFE patients who had undergone in situ fixation with cannulated screw were included in the study. The mean age and follow up were 12.33 years (range, 7-16) and 42.24±16.65 months, respectively. The hips were grouped regarding to chronicity; acute, acute on chronic and chronic slips. The patients were also regrouped regarding the stability of the slip. Pre-and postoperatively both antero-posterior and frog leg pelvis radiographies were evaluated to measure Southwick slip angles and the number of screw threads. Results: Metabolic or endocrinologic pathologies were observed in 13 patients. During the follow up four hips were reoperated due to the insufficiency of the screw threads passing across the physeal line. The mean number of the screw threads was 1,85 (range, 0-3) for the revised hips and 3.87 (range, 2-5) for the rest. The mean slip angle was 37.88°±15.2° preoperatively. Postoperatively, the angle was reduced to 29.00°±16.41° (p=0.0001). Postoperative slip angles were significantly different between chronicity groups (p=0.019). In the acute slip group, mean slip angle was 21.00°±11.08° whereas in the chronic group it was 42.22°±17.98° (p=0.009). Conclusion: It was concluded that in the surgical treatment of SCFE with a single screw, the number of screw threads passing across the epiphyseal line should be at least four; otherwise fixation would not be stable enough.Key words: Slipped capital femoral epiphysis, adolescent obesity, in-situ fixation, screw threads ÖZ Amaç: Adölesanlarda obezite ile birlikte sık görülen bir hastalık olan femur başı epifiz kaymasının (FBEK) tedavisi kanüllü vida ile in-situ tespittir. Bu çalışmada, tek kanüllü vida ile tedavi edilen FBEK'lerde epifizi geçen yiv sayısı ile stabilitenin ilişkisini saptamak amaçlanmıştır. Yöntem: 2008-2013 yılları arasında kanüllü vida ile opere olan 25 FBEK hastasının 33 kalçası pre op ve post op olarak klinik ve radyolojik olarak değerlendirildi. Kalçalar etiyolojisine göre akut, kronik zeminde akut ve kronik olmak üzere gruplandırılırken, stabilite açısında gruplandırıldılar. Radyolojik olarak kalça tam AP ve frog-leg pozisyonlarında, operasyon öncesi ve sonrası Southwick açıları (epifiz-diafiz açısı), operasyon sonrası epifiz hattını geçen yiv sayıları ölçüldü. Bulgular: On üç olguda metabolik veya endokrinolojik patoloji gözlendi. Tek kanüllü vida kullanılarak opere edilen olguların 4'ünde cerrahi sonrasında kayma açılarında artış olduğu göz-lendi ve revize edildi. Bu 4 kalçada ön-arka ve frog-leg pozisyonlardaki grafilerde değerlendiri-len epifiz hattını geçen yiv sayısı ortalaması 1.85 idi. Kayma açısında artış olmayan 2...

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“…Accordingly, localised corrosion of the screws based on these materials may occur. Therefore, the purpose of the fixation is to provide adequate epiphysial stability for the time of growth and to prevent future slipping of the femoral head while also promoting premature physeal closure [11]. Though normal body fluids have a neutral pH (7.4), an acidic condition was reported at the implanted site of the bone fracture [21].…”

Section: Discussionmentioning

confidence: 99%

The stainless steel screw as an orthopaedic implant

Rozman¹,

Kmetič

Bunc

et al. 2002

Materials & Corrosion

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Corrosion ConceptsIn dieser Rubrik ko Ènnen Sie, die Leser, praxisorientierte Beitra Ège zur Diskussion stellen. Es werden Korrosionsprobleme, aber auch Lo Èsungswege und praktische Erfahrungen vero Èffentlicht. Damit soll der Erfahrungsaustausch unter den Lesern dieses Periodikums zu einer sta Èndigen Einrichtung werden. Vor allem die Praktiker und die ¹Senior Scientistsª sind aufgefordert, von ihrem reichhaltigen Wissen abzugeben. Wir bitten Sie um Ihre Mitarbeit in Form von Beitra Ègen und Leserbriefen.In this forum readers will be able to present practical problems for discussion. It is envisaged that these contributions will include not only discussion of general problems and incidents of corrosion but that suggested remedies will also be presented and discussed. It is hoped that this exchange of knowledge and experience will become a permanent feature of this periodical. We are particularly anxious that both Senior Scientists and those with more practical experience will make use of this forum to exchange information, problems and potential remedies.The study reported here dealt with the metallographical inspection and analysis of corrosion behavior of screws for mild Slipped Capital Femoral Epiphysis (SCFE), which is a serious orthopedical problem in early adolescence. The screws were fabricated from low carbon, austenitic grade stainless steel type 316L (AISI) with 1600 ppm of nitrogen (316LN2). They were clinically tested in a nearly 25-year-long study where patients in early adolescence were operated with these screws with the fixation in situ. Since the results obtained in all patients were similar, we present the results obtained in screws removed after 3 years of implantation from a 14-year-old boy. Metallographical inspection results reveal that a low content of carbon in the SS 316LN2, and annealing this material at a high temperature ensures the monophasic microstructure of austenitic grains. In the grains twin bands that appeared during mechanical deformation were observed. As the hardness measured at the stalk (262 HV) was lower than that measured at the head of the screw (293 HV) it was concluded that cold mechanical deformation of the head was much more extensive than that of the stalk. Accordingly, corrosion of the head could be more probable than that of the stalk. Corrosion behavior of the screw in simulated physiological media (0.9% NaCl solution), carried out by the electrochemical method, gave an E corr of À0.124 V (vs. SCE), corrosion current density of 21 nA/cm 2 , and corrosion rate of 0.010 AE 0.005 mpy. This low corrosion rate indicates that Die Hu Èftsteife ± Slipped Capital Femoral Epiphysis (SCFE) ist eine spontane puberta Ère Erkrankung. In der vorliegenden Arbeit werden die Ergebnisse einer metallographischen Untersuchung und der Korrosionsmessungen von Schrauben fu Èr SCFE dargestellt. Die Korrosionsmessungen wurden zur Bestimmung des Korrosionsverhaltens von Schrauben durchgefu Èhrt. Die Schrauben wurden aus rostfreiem kohlenstoffarmen austenitischen Stahl 316L (AISI) mit 160...

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Acute slipped capital femoral epiphysis

Cited by 543 publications

References 16 publications

Slipped capital femoral epiphysis: a population-based study

Slipped capital femoral epiphysis: a population-based study

Does the number of engaged screw threads affect the stability of slipped capital femoral epiphysis insitu fixation?

The stainless steel screw as an orthopaedic implant

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