Young children in particular may have difficulty localizing or communicating the location of their pain; and sometimes children who initially seem to have a hip problem actually have underlying pathology of the knee or foot. In children from 2 to 10 years old with symptoms less than 5 days, and in the absence of high fever or elevated inflammatory markers - a wait-and-see policy is recommended. In these cases the diagnosis is usually transient synovitis, which is a spontaneously resolving condition. Sometimes the referring physician will request an ultrasound to confirm the presence of a joint effusion. The diagram shows a practical approach to hip pain and a new limp. Click on the image to enlarge.

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Publication date Print : December Mientras tanto, el choque femoro-acetabular provoca dano irreversible del cartilago articular. El proposito del trabajo es determinar si la remodelacion es suficiente para impedir el deterioro articular en el corto plazo.

Se evaluo la capacidad de remodelacion con el angulo de Southwick y el angulo alfa. El deterioro funcional se evaluo con el puntaje de Harris y el radiologico, con la escala de Tonnis. Seguimiento minimo: 4 anos. Resultados: Diecisiete pacientes, mediana de seguimiento: 63 meses RI El angulo de Southwick prequirurgico 57o RI versus el posquirurgico 48o RI disminuyo significativamente p 0, Lo mismo ocurrio con el angulo alfa complementario.

El deterioro radiologico evaluado con la escala de Tonnis fue estadisticamente significativo p 0, Los resultados funcionales, cuantificados con el puntaje de Harris no mostraron diferencias estadisticamente significativas p 0, Conclusiones: En esta serie, las epifisiolisis moderadas y graves fijadas in situ presentaron deterioro radiologico en 63 meses de seguimiento promedio.

Sin embargo, la funcionalidad no se deterioro con la misma rapidez. Background: After stopping the slip progression, hips undergo a remodeling complex phenomenon. Meanwhile femoro-acetabular shock causes irreversible joint cartilage damage. The purpose of the study is to determine if remodeling is sufficient to prevent joint deterioration in the short-term. Methods: A retrospective cohort study of patients with moderate and severe landslides, treated with in situ fixation was designed.

Remodeling capacity was evaluated with Southwick angle and alpha angle. Functional and radiological impairment was evaluated with the Hip Harris Score and Tonnis scale, respectively. Minimum follow-up: 4 years. Results: Seventeen patients, median follow-up 63 months IR The pre-surgical Southwick angle 57o IR versus the postoperative one 48o IR significantly decreased p 0. The same happened with the complementary angle alpha. The radiological deterioration was statistically significant p 0.

Functional results showed no statistically significant differences p 0. Conclusions: In this series, moderate and severe slipped capital femoral epiphysis fixed in situ showed radiological deterioration during a month follow-up.

However, the functionality is not deteriorating as quickly. Data availability:. ScienceOpen disciplines: Orthopedics , Physiotherapy. Read this article at SciELO. There is no author summary for this article yet.

Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience. Jorge Sueiro: Role: ND. Eduardo Stefano: Role: ND. Journal ID publisher : raaot. Abbreviated Title: Rev.

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Background: Slipped capital femoral epiphysis, a common disorder in adolescents, may be increasing in incidence in North America because of the obesity epidemic. In most cases, the slip is mild and can be treated with in situ fixation. Even in more severe cases of a stable slip, in situ fixation remains a widely accepted choice. When the slip is acute and unstable, treatment remains controversial. We reviewed the orthopaedic literature and our personal experience in managing acute, unstable slipped capital femoral epiphysis.


Acute, Unstable, Slipped Capital Femoral Epiphysis: Is There a Role for in Situ Fixation?

Average 4. Thank you for rating! Please vote below and help us build the most advanced adaptive learning platform in medicine. Just skip this one for now. He is found on imaging to have a severe slipped capital femoral epiphysis. If his leg is not manipulated for imaging, in what abnormal position is his left hip most likely to appear on an anteroposterior pelvic radiograph?

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