RESUMO
BACKGROUND: In slipped capital femoral epiphysis (SCFE), the femoral head slides in an anterosuperior direction along the growth plate. The femoral head remains in the acetabulum. The pathogenesis of SCFE is multifactorial. An important predisposing factor is obesity. PROBLEM: Epiphysiolysis can compromise the blood supply to the epiphysis and osteonecrosis of the femoral head may result. DIAGNOSTICS AND PROGNOSIS: Conventional radiography represents the first diagnostic step. The long-term prognosis of the disease depends on the residual deformity of the femoral head and in the worst case may result in early osteoarthritis of the hip joint.
Assuntos
Osteoartrite do Quadril , Escorregamento das Epífises Proximais do Fêmur , Humanos , Escorregamento das Epífises Proximais do Fêmur/diagnóstico por imagem , Escorregamento das Epífises Proximais do Fêmur/cirurgia , Articulação do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/diagnóstico por imagem , Osteoartrite do Quadril/etiologia , Radiografia , Cabeça do Fêmur/diagnóstico por imagemRESUMO
BACKGROUND: The Monteggia lesion is a rare injury of the elbow in children. This lesion is defined as a shaft fracture of the ulna combined with a luxation of the radial head. The primary problem in this injury is the proper diagnosis because the misalignment of the radial head is often missed. The purpose of this study was to retrospectively analyse the results after Monteggia lesions in children. PATIENTS AND METHODS: Ten children between two and nine years of age (six boys and four girls) were clinically assessed using the Morrey score. They were treated in our department between December 1999 and October 2004. RESULTS: The Morrey score after 54 months (min.: 26/max.: 84) had a median value of 100 points with 100 being the maximum (min.: 95/max.: 100). We found two complications, a combined lesion of the radial and ulnar nerves which completely recovered after six months. In one case a k-wire dislocated, which was removed earlier. DISCUSSION: If the Monteggia lesion in children is correctly diagnosed and treated early enough, only good and very good results may be expected. After delayed diagnosis and treatment, the clinical results are not as good or even very poor.
Assuntos
Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Fratura de Monteggia/diagnóstico por imagem , Fratura de Monteggia/cirurgia , Criança , Pré-Escolar , Diagnóstico Tardio , Feminino , Seguimentos , Fixação Interna de Fraturas , Fixação Intramedular de Fraturas , Consolidação da Fratura/fisiologia , Humanos , Masculino , Fratura de Monteggia/classificação , Complicações Pós-Operatórias/diagnóstico por imagem , Prognóstico , Radiografia , Amplitude de Movimento Articular/fisiologia , Estudos RetrospectivosRESUMO
Both traumatic and congenital dislocation of the radial head are very rare in childhood. It can sometimes be difficult to tell them apart in practice. In this paper therefore, we present one case and discuss the various aspects of both conditions with reference to the available literature. Traumatic dislocation of the radial head is generally easily reduced without open surgery, and an open procedure is virtually never indicated in a patient who is still growing. In contrast, specific treatment of congenital radial head dislocation is not necessary because most patients are free of pain.