Orthopedics Book

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Slipped Capital Femoral Epiphysis

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  1. See Also
    1. Pediatric Limp
  2. Epidemiology
    1. Occurs during maximal pubertal growth spurt
      1. Males: age 13 to 15 years
      2. Females: age 11 to 13 years
    2. Most common adolescent hip disorder
      1. Incidence: 1 to 4 per 100,000
    3. Black race affected more often than white race
    4. Unilateral involvement in 90% of cases
    5. Child is often overweight
  3. Pathophysiology
    1. Occurs before the epiphyseal plate closes
  4. Signs
    1. Hip held in abduction and external rotation
    2. Markedly limited internal rotation
  5. Radiology: Hip XRay (Compare sides)
    1. Widened epiphyseal plate
    2. Displacement of femoral head
  6. Management
    1. Orthopedic Emergency!
    2. Immediate hospitalization and operative fixation
    3. Spica hip casting for 6 to 8 weeks
      1. Decreases risk of Femoral Neck Fracture
      2. Protects epiphyses
    4. Severe chronic Slipped Capital Femoral Epiphyses
      1. Requires osteotomies to realign and stabilize

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