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Valgus Slipped Capital Femoral Epiphysis Reviewed
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Posted on: 03/17/2010
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Slipped capital femoral epiphysis is a condition where the upper part of the femur (thigh bone) slips backwards, out of place. It affects adolescents, usually just after puberty. Because the condition isn't all that common, the authors of this article reviewed their particular institution's experience with dealing with valgus (turning outward) slipped capital femoral epiphysis.
Researchers reviewed cases of children who had undergone surgery to correct the disorder. The researchers divided the cases into either classic (varus) or valgus. If it wasn't clear as to which type the child had, he or she was not included in the study. In all, 12 children with valgus slipped capital femoral epiphysis were identified.
The researchers made note of the patients' demographic information (age, gender), their x-rays and clinical notes when they first arrived at the institution, treatment, and follow-up. They also measured hip stability (ability to bear weight). In order to compare results, the researchers also looked at 123 x-rays of atients who had been diagnosed with the classic form of the disorder.
What was found was that valgus slipped capital femoral epiphysis occurred in only 4.7 percent of the cases overall (12 out of 258 patients). Fifty-eight percent of the patients were girls and four patients were diagnosed with endocrine abnormalities. The endocrine system is the part of the body that controls growth, development, tissue function, and more. One patient had been diagnosed with Stickler syndrome, a connective tissue disorder. Interestingly, the patients who had the valgus type of disorder had their femoral neck angle that was higher than those who had the varus type.
To manage the problem, surgery was performed on 11 of the patients. Screws were inserted to stabilize the hip. None of the patients experienced any significant complications as a result of the surgery, however the surgical procedure itself was difficult to perform in five patients. During follow-up, two patients experienced complications. one had to have the hardware removed from the hip and the other needed additional hardware inserted.
In conclusion, the authors wrote that valgus displacement may look fairly normal on x-rays taken from the front of the hip (anterior). Patients with the valgus type are often most likely to be obese, have an endocrine imbalance, or have Stickler syndrome. Surgical correction can be difficult, but results are usually successful.
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References:
Craig F. Shank, MD, Eric J. Thiel, MD, and Kevin E. Klingele, MD. Valgus Slipped Capital Femoral Epiphysis: Prevalence, Presentation, and Treatment Options. In Journal of Pediatric Orthopaedics. March 2010. Vol. 30. No. 2. Pp. 140-146.
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