Epifisiolisis y hormona de crecimiento recombinante / Epiphysiolysis and recombinant growth hormone

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Incidencia y prevalencia de fracturas atendidas en la emergencia del Servicio de Ortopedia y Traumatología del Hospital Central de San Cristóbal - Estado Táchira, Venezuela. Mayo 2012 - mayo 2013 / Incidence and prevalence of fracture admitted in the orthopedics and traumatology emergency in San Cristobal central hospital, Tachira state, Venezuela. May 2012 - may 2013

Se realizó un estudio prospectivo descriptivo y observacional, exhaustivo tipo censo, donde se evaluaron a 5348 pacientes que acudieron con fracturas y/o epifisiólisis a la emergencia de Ortopedia y Traumatología del Hospital Central de San Cristóbal- Estado Táchira, Venezuela; desde mayo de 2012 a mayo de 2013. El Objetivo general de este estudio es determinar la incidencia y prevalencia de fracturas atendidas en este centro asistencial, así como conocer las causas y los mecanismos de lesión más frecuentes. Se aplicó un esquema de diagnóstico clínico e imagenológico, una vez hecho el diagnóstico de fractura y/o epifisiólisis del esqueleto apendicular y cintura pélvica, las lesiones se ubicaron topográficamente. El mayor porcentaje de fracturas se localizó en la extremidades inferiores a nivel de diáfisis de fémur, diáfisis de tibia, fémur Proximal y meseta tibial agrupando estas cuatro un 42,2 % del total de todas las fracturas evaluadas, además este estudio reportó una incidencia de fracturas abiertas de un 15,20%; encontrando una incidencia de 7,69 % para las epifisiólisis. Se concluye que los accidentes de tránsito s el mecanismo de lesión más frecuente en todas las fracturas y de este grupo los accidentes en moto representan el de mayor incidencia, siendo la población más expuesta los estudiantes y Obreros(AU)

We performed prospective, descriptive, observational study was conducted exhaustive census type, where 5348 patients presenting with fractures and epiphysiolisys admitted in the orthopedics and traumatology emergency in San Cristobal central hospital, Táchira state, Venezuela, were evaluated; from may 2012 to may 2013. The overall objective of this study is to determine the incidence and prevalence of fractures treated at this medical center, as well as the causes and mechanisms of injury frequently. An outline of clinical and imaging diagnosis was applied, once the diagnosis of fracture and / or epiphysiolisys appendicular skeleton and pelvic girdle made , lesions were located topographically. The highest percentage of fractures were located in the lower limbs level midshaft femur diaphysis of tibia, femur and tibial plateau proximal giving a total of 42.2% of all fractures evaluated, this study also reported an incidence of open fractures of 15.20%; found an incidence of 7.69% for epiphysiolisys. In conclusion traffic accidents are the most common mechanism of injury in fractures in this group. and motorcycle accidents account for the highest incidence, also, the most exposed population are students and workers(AU)

Slipped capital femoral epiphysis with severe vitamin D deficiency.

Slipped capital femoral epiphysis is a relatively common disorder in late childhood and early adolescence, with an incidence in the United States of approximately 10 per 100,000. Although clinicians have theorized that contributing factors to the development of slipped capital femoral epiphysis include 25-hydroxyvitamin D deficiency and other nutritional deficiencies, the roles of these factors have not been fully analyzed. This article presents a case of a morbidly obese 13-year-old African-American boy who presented with sudden worsening of chronic hip pain and was diagnosed with stable, bilateral, grade-III slipped capital femoral epiphysis and severe vitamin D deficiency. He was initially treated with bilateral single-screw percutaneous fixation, however, after continued pain and nonunion, a right valgus subtrochanteric osteotomy was performed in association with correction of his severe vitamin D deficiency. This procedure led to improvement of his hip function and successful resolution of the pain. Approximately 3 months after the second operation and vitamin supplementation, the patient had signs of union, and his weight bearing progressed without discomfort. Although the osteotomy provided substantial biomechanical advantage by changing the forces across the physis from shear to compressive, correction of the vitamin D deficiency was critical in providing metabolic capacity for bone healing. Vitamin D plays an important role in bone formation and development, but the level of 25-hydroxyvitamin D is not routinely measured during assessment and treatment of slipped capital femoral epiphysis patients. The early detection and proper treatment of vitamin D may assist in the treatment of patients with slipped capital femoral epiphysis.

Slipped Upper Femoral Epiphysis (SUFE): to do or not to do in sufe.

Slipped upper femoral epiphysis (SUFE) is not an uncommon hip disease in adolescence. Usually, diagnosis of SUFE is delayed, has high risk of sequela and poor long-term results. This paper reviews the literature with a focus on epidemiology, aetiology, diagnosis, treatment and results regarding SUFE.

Cone epiphysis of the knee and scurvy.

A rare case of metaphyseal cupping of the distal femur resulting from infantile scury in a child is reported. The radiological and surgical aspects of this case are of particular interest. MRI demonstrated central epiphysiodesis of the right knee, surgery achieved rupture of the epiphyseal plate and resulted in femoral lengthening. The child's limp disappeared as a result.

[The pathogenesis of epiphysiolysis in swine]. / Ein Beitrag zur Pathogenese der Epiphyseolysis beim Schwein.

In the offspring of a sow suffering from epiphyseolysis a unilateral and bilateral epiphyseolysis occurred associated with high energy food and also partly due to low mineral food in 4 out of 7 piglets. A further animal showed apophyseolysis. Compared to the normal piglets there was no difference observed concerning the parameter of the bone metabolism (Ca, P, alk. phosphatase) and the size of angles between shaft and neck of the femur. Serial X-ray examinations revealed osteolytic changes in the cortex of the femur neck, starting before epiphyseolysis was evident and which could be proved to be in the macerated bones of the affected piglets. The etiology of these pre-epiphyseolytic changes as a segue of vascularisation disorders in the bone and its significance for the pathogenesis of epiphyseolysis are discussed.