Abos - Pediatric Ortho Surgery:pediatric Lower Extremity:slipped Capital Femoral Epiphysis

Front 1

What patient population is at greatest risk for slipped capital femoral epiphysis (SCFE)?

Back 1

African-American boys
Age 10 to 16

Front 2

What are the two primary risk factors?

Back 2

Family history
Obesity

Front 3

How often is involvement bilateral?

Back 3

25%

Front 4

What two other disorders are associated with SCFE development?

Back 4

Hypothyroidism
Renal disease

Front 5

What are two other iatrogenic associations?

Back 5

Growth hormone therapy
Radiation treatment

Front 6

What two effects does growth hormone have on the growth plate?

Back 6

Stimulates proliferation
inhibits maturation (keeps growth plate open)

Front 7

What are two thyroid hormone effects?

Back 7

Stimulates proliferation
Stimulates maturation (closure of the growth plate)

Front 8

What four SCFE patient groups ought to have an endocrine evaluation?

Back 8

<10 years old
>16 years old
<10th percentile for weight
Bilateral involvement

Front 9

What does a biopsy of zone of provisional calcification show?

Back 9

Granulation tissue between columns

Front 10

In which two directions does the femoral neck slip?

Back 10

Anterior
Superior

Front 11

In which two directions does the epiphysis slip?

Back 11

Posterior
Inferior

Front 12

What are the three grades of slip?

Back 12

I: <% 1/3
ll: % 1/3 to % 1/2
lll: >% 1/2

Front 13

What key physical exam finding is suggestive of SCFE?

Back 13

Obligate external rotation with
flexion

Front 14

Compare the rate of osteonecrosis with stable and unstable SCFE?

Back 14

Stable: 0% develop AVN
Unstable: 50% develop AVN

Front 15

When performing surgery on a patient <10 years old, what procedure should be considered?

Back 15

Pinning of contralateral side also

Front 16

Compare postoperative weight-bearing status with stable and unstable SCFE.

Back 16

Stable: weight—bearing as tolerated (WBAT)
Unstable: non-weight-bearing (NVVB)