TOTBİD Dergisi

TOTBİD Dergisi

2014, Cilt 13, Sayı, 5     (Sayfalar: 441-448)

Current diagnostic and therapeutic approach to patients with slipped capital femoral epiphysis

Mehmet Ali Talmaç 1, Hasan Basri Sezer 1

1 Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul

DOI: 10.14292/totbid.dergisi.2014.50
Görüntüleme: 715
İndirme : 5243

Slipped capital femoral epiphysis (SCFE) is defined as the disruption of the relationship between the proximal femoral epiphysis and the femoral neck because of softening of the proximal femoral physis and increased shear forces due to rapid growth and increased body weight during puberty. It has a prevalence of 10.8 in 100 000. The usual presentation of the patients is overweighted male adolescent with complaints of groin, thigh or knee pain and a limp. It is mostly idiopathic, however the patient might be affected by endocrine, nephrological conditions or it may be due to radiotherapy. The physical examination reveals limitation of hip motion, and patients have tendency to position their lower extremity externally rotated and flexed. Almost half of the patients are affected bilaterally. Thus, there rises a debate about prophylactic in situ pinning. SCFE is classically classified in two categories: 1) according to the time of onset as acute, acute-on-chronic and chronic, and 2) according to the stability as stabile or instabile. In case of failed treatment, SCFE has devastating results like avascular necrosis, chondrolysis, and femoroacetabular impingement resulting in early arthrosis. In this paper we attempt to increase the awareness on the ethiopathology, diagnosis, progression and current treatment modalities of SCFE.

Anahtar Kelimeler : femoral head; dislocation, epiphysis; femur head necrosis