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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Tillaux Fractures

How important is this topic for clinical practice? As the physis becomes more oblique, shear forces across the growth plate increase and result in an increased risk of fracture and resultant slippage. 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.

Radiographs recommended views AP mortise lateral optional views full-length tibia or proximal tibia to rule out Maisonneuve-type fracture CT scan indications assess fracture displacement best obtained post-reduction assess articular step-off preop planning. SCFE is associated with a greater risk of arthritis of the hip joint later in life. However, it should not be used as a replacement for a pelvic radiograph.

He is now unable to place weight on the left lower extremity, even with the assistance of crutches.

HPI – Twisting injury 4 hours ago No prior pain or history of trauma. She has no complains in the hips. Marrow edema is non-specific, and while it may indicate early bone changes in SUFE, there are numerous other causes, e.


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Pediatric Orthopaedic Society of North America. It is actually the metaphysis neck part of a bone which slips in an anterior direction with external rotation. Provides prognostic information for epifisoilisis of femoral head osteonecrosis. By using this site, you agree to the Terms of Use and Privacy Policy. Ultrasound may be performed in the assessment of hip pain.

Gonad protection is usually used in pelvic x-rays of children. His pain has significantly worsened over the past week. Almost all cases require surgery, which usually involves the placement of one or two pins into the femoral head to prevent further slippage.

Open reduction and pinning with multiple cannulated screws in an inverted triangle configuration. Also, the axis of the physis alters during growth and moves from being horizontal to being oblique.

Preoperative radiographs are seen in Figure A, radiographs six months after in situ fixation are seen in Figure B. Her parents femorsl that outside radiographs were interpreted to be normal.

Synonyms or Alternate Spellings: Distal epiphysiolysis of the femur. Consultation with an orthopaedic surgeon is necessary to repair this problem.

Slipped Capital Femoral Epiphysis (SCFE)

Knee radiographs, including stress views, are negative. Prevalence, Pathogenesis, and Natural History”. A SCFE is an orthopaedic emergency, as further slippage may result in occlusion of the blood supply and avascular necrosis risk of 25 percent. Closed reduction and pinning with multiple cannulated screws in an inverted triangle configuration.

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The metaphysis is displaced laterally and therefore may not overlap posterior lip of the acetabulum as it should normally loss of triangular sign of Capener 5. Case 15 Case How important is this topic for board examinations? Skeletal changes may also make someone at risk of SCFE, including femoral or acetabular retroversion, [5] those these may simply be chronic skeletal manifestations of childhood obesity.

Loder Classification — based on ability to bear weight. epifisiolisiss

Tillaux Fractures – Pediatrics – Orthobullets

Associated with decreased femoral anteversion and decreased femoral neck-shaft angle. Is the closed reduction acceptable? His radiographs are shown in Figures A and B. What is the most appropriate treatment? Edit article Share article View revision history. Please login to add comment. You can change the settings or obtain more information by clicking here.


Ankle Fractures – Pediatric – Pediatrics – Orthobullets

Articles Cases Courses Quiz. SCFE is the most common hip disorder in adolescence. A dressing covers the wound. Log in Sign up.

SCFEs are most common in adolescents 11—15 years of age, [7] and affects boys more frequently than girls male 2: The disease can be treated with external in-situ pinning or open reduction and pinning. While trauma has a role in the manifestation of the fracture, an intrinsic weakness in the physeal cartilage also is present.