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At least 253 records · Page 14Linked to original sources

PubMed1984

Development of the distal femoral epiphysis: a microscopic morphological investigation of the zone of Ranvier.

The distal femoral epiphysis, physis, and contiguous metaphysis were examined radiographically, morphologically, and histologically in 97 human specimens ranging in age from 9 prenatal weeks to 16 postnatal years. The earliest development of the femoral anlage was characterized by patterns of appositional and interstitial chondrogenesis throughout its entire structure. Once central endochondral ossification began, chondrogenic interstitial and appositional growth became regionally restricted to the femoral epiphyses. Interstitial chondrogenesis became limited to the germinal region of the developing physis, and appositional chondrogenesis was restricted to the region of loosely packed cells of the perichondrial ossification zone of Ranvier. Appositional chondrogenesis within the perichondrium appears to make its greatest contribution to transverse expansion of the distal femoral epiphysis during the first 5 months of gestation. After the sixth month of gestation, the perichondrial appositional growth contribution appears to decline steadily.

Adolescent↗

PubMedDate not supplied

Slipped capital femoral epiphysis associated with hyperparathyroidism.

Slippage of the upper femoral epiphysis can occur in association with multiple endocrine imbalances. This report documents the second case of primary parathyroid adenoma with hyperparathyroidism and symptomatic concomitant slipped capital femoral epiphyses. In the evaluation of children with slipped capital femoral epiphysis, care must be taken to eliminate other treatable disease states that are known to be associated with this phenomenon. The capital femoral physes in this child with hyperparathyroidism promptly closed following removal of the parathyroid adenoma.

Adenoma↗

PubMedDate not supplied

Transtrochanteric anterior rotational osteotomy for slipped capital femoral epiphysis: a report of five cases.

We have performed a transtrochanteric anterior rotational osteotomy on five patients with severe chronic slipped capital femoral epiphysis. Four patients were free from clinical symptoms, whereas one patient continued to feel a dull pain in the hip. Radiographic evaluation indicated that the osteotomy was able to correct even a severe slip without any deformity around the trochanteric region. There were complications in two cases: a posteromedial tilt at the osteotomy site and a focal avascular necrosis in the anterolateral epiphysis.

Adolescent↗

PubMedDate not supplied

Acetabular epiphysis-labrum entrapment following traumatic anterior dislocation of the hip in children.

Traumatic anterior dislocations of the hip during childhood are rare injuries. Although a concentric reduction can usually be achieved with closed techniques, open reduction is occasionally required. We recently treated two children, 10 and 13 years of age, with nonconcentric closed reductions following traumatic anterior dislocation sustained 6 weeks and 6 months previously, respectively. Preoperative evaluation revealed intraarticular entrapment of the acetabular epiphysis and its contiguous labrum as the cause of the nonconcentric reduction. This was confirmed at surgery. Although displacement of the acetabular epiphysis has not been previously described, it is probably a common source for cartilaginous and osteocartilaginous fragments that have been recognized at open reduction following both traumatic anterior and posterior hip dislocations in children. Damage to this secondary center of ossification does not appear to affect adversely further growth and development of the acetabulum.

Acetabulum↗

PubMedDate not supplied

Coexistent Legg-Calvé-Perthes disease and slipped capital femoral epiphysis in the same child.

Legg-Calvé-Perthes disease and slipped capital femoral epiphysis in the same child occurs rarely. Three cases from Indiana University Medical Center (Indianapolis, IN) are reported. The two disease entities appear to be unrelated. However, a child with Legg-Calvé-Perthes disease in one hip may develop a slipped capital femoral epiphysis in the contralateral hip.

Child↗

PubMedDate not supplied

The evolving slope of the proximal femoral growth plate relationship to slipped capital femoral epiphysis.

We measured the physeal angle (slope) of the proximal femoral physis on the standard anteroposterior (AP) radiographs. Controls consisted of 307 hips in children aged 1-18 years. Similar measurements were made on the affected (slip) and unaffected (nonslip) sides of 107 children with manifest unilateral slipped capital femoral epiphysis. An age-related increase of 14 degrees occurs in the slope of the proximal femoral physis between ages 1 and 18 years, with maximal increase between ages 9 and 12 years. Increasing obliquity of the proximal femoral physis may be yet another factor contributing to slipped capital femoral epiphysis.

Adolescent↗

PubMedDate not supplied

Anterolateral approach to the hip for bone graft epiphysiodesis in the treatment of slipped capital femoral epiphysis.

In an effort to accommodate the needs of the majority of orthopedic surgeons who might encounter cases of slipped capital femoral epiphysis, an operative approach familiar to everyday practice was sought. Thirty-two cases of slipped capital femoral epiphysis were treated by bone graft epiphysiodesis using an anterolateral approach in contrast to the more traditionally used iliofemoral (Smith-Peterson) approach. Experience has shown this to be a better approach based on reduced operating time, less blood loss, avoidance of damage to the lateral femoral cutaneous nerve, improved wound healing, and for the operating surgeon, familiarity with an exposure utilized in total hip replacement.

Epiphyses↗

PubMedDate not supplied

The HLA phenotype in slipped capital femoral epiphysis.

The HLA genotypes of six patients with acute grade I slipped capital femoral epiphysis as determined by microlymphocytotoxic technique revealed HLA-DR4 as their phenotypes. These results contradict the previously reported HLA-B12 as the phenotype of patients with slipped capital femoral epiphysis.

Adolescent↗

PubMed2007

Potential influence of hormones in the development of slipped capital femoral epiphysis: a preliminary study.

The potential influence of hormonal imbalance on the development of slipped capital femoral epiphysis was assessed through a prospective clinical study. The serum levels of T3, T4, thyroid-stimulating hormone, testosterone, estradiol, dehydroepiandrosterone-sulfate, follicle-stimulating hormone, luteinizing hormone, human growth hormone, adrenal cortex hormone and cortisol were evaluated in seven boys and seven girls. Forty-three out of 154 hormonal determinations (27.9%) were abnormal. The results showed increased incidence of pathological values mainly in the levels of follicle-stimulating-hormone, luteinizing-hormone and testosterone. No patient had clinical findings of endocrinopathy. A (possibly) temporary hormonal disorder may play a potentially significant role in the development of slipped capital femoral epiphysis.

Adolescent↗

PubMed2003

Fracture of the proximal tibial epiphysis and tuberosity in 10 dogs.

Ten dogs were presented with fractures of the proximal tibial epiphysis and tuberosity. All dogs had a cranioproximal-caudodistal angulation of the tibial plateau. Six dogs had marked caudal displacement of the proximal tibial epiphysis, five of which had also sustained fractures of the proximal fibula. The estimated mean angle of inclination of the tibial plateau of affected limbs was 45.8 +/- 9.6 degrees, which was significantly greater (P<0.0005) than the estimated mean angle of the normal contralateral limb 26.2 +/- 6.6 degrees. The mean angle of inclination of the tibial plateau of dogs with fibular fractures (n=5) was not significantly different from dogs without fibular fractures (n=5) (P>0.25). Five dogs were treated conservatively and five were treated by three different methods of surgical repair. Surgically treated dogs had significantly greater preoperative tibial plateau angles (P<0.05). All dogs regained full limb usage, regardless of the method of treatment chosen.

Animals↗

PubMed1995

Changes in intraosseous pressure at the distal femoral epiphysis induced by variations in knee-joint position and intracapsular saline infusion. An experimental study in dogs.

Hemodynamic changes at the distal femoral epiphysis measured by recording intraosseous pressure (IOP) were investigated in mature and juvenile dogs after changes in knee-joint position and intracapsular infusion of 3 ml isotonic saline solution. Juvenile and mature animals responded to infusion test with a similar 5-fold increase in intracapsular pressure. A 2-fold increase in IOP was found when knee-joint flexion passed from 30 degrees to complete flexion. In juvenile dogs, IOP values were lower than in adults both in complete knee flexion and during infusion test. The similar response to joint hyperpressure tests observed in adult and juvenile dogs suggests that the barrier effect of the growth plate for epiphyseal venous drainage has no major influence in the hemodynamics of the distal femoral epiphysis.

Animals↗

PubMed1977

Influence of growth hormone and thyroxine on endochondral osteogenesis in the mandibular condyle and proximal tibial epiphysis.

Interrelationships of growth hormone and thyroxine effects on endochondral osteogenesis have been investigated. Evidence is offered that thyroxine augments the effect of growth hormone on the mandibular condyle just as at other osteogenetic centers, for example proximal tibial epiphysis in hypophysectomized rats. This contrasts with previous reports of a unique thyroxine antagonism to the effect of growth hormone on condylar development. In a further study on tibial epiphysis, special attention was given to assure absence of the endogenous thyroid hormone by adding thyroidectomy to hypophysectomy and reducing the possibility of thyroteopin residues in growth hormone. By histochemical tests, the responses of both calcified and noncalcified regions of the epiphyseal cartilage plate were measured. Graded growth hormone doses stimulated graded response in a noncalcified region. Thyroxine augmented this response eightfold. The width of the calcified region of the plate did not vary with treatment.

Animals↗

PubMed1986

Ossification centre of the hyoid bone in complete transposition of great vessels, Ivemark asplenia syndrome, and Down's syndrome with congenital heart disease: correlation with the humeral capital epiphysis.

The incidence of radiographic visibility of the ossification centres of the body of the hyoid bone and of the humeral capital epiphysis in antero-posterior or lateral chest radiographs taken during the first month of life of 63 autopsied infants were analysed. The group comprised patients with Down's syndrome (DS) with congenital heart disease, 15; complete transposition of the great vessels (TGV), 10; Ivemark asplenia syndrome (IS), 17; and a control group of infants with congenital heart disease (CHD) who had none of the above conditions, nor tetralogy of Fallot, interrupted aortic arch, DiGeorge syndrome or hypoplastic left-heart complex, 31. The incidence of radiographically visible hyoid ossification centre (HOC) in the control group was 71% and of humeral capital epiphysis (HE), 16.1%. Autopsied infants with TGV, IS or DS with CHD showed increased visibility of HOC (100%); the incidence of visible HE was increased in neonates with IS (71.4%) and with TGV (50%). The differences in the incidence of radiographic visibility of HOC and HE in neonates with CHD, in this study and in others in the literature, appear to have diagnostic value.

Age Factors↗

PubMed1996

Changes in bone metabolism and epiphysial growth plate in bovine Hyena disease induced by administration of vitamin AD3E premix or Vitamin A.

The changes in bone metabolism and morphology of chondrocytes in bovine Hyena disease caused by administration of vitamin AD3E premix (V-AD3E) or vitamin A (V-A) were examined. At the each age, 5 calves were used. Among them, Hyena disease was recognized in 3 calves; a calf administered a high dose of V-AD3E premix (V-A 3,000,000, V-D3 300,000, and V-E 1,200 I.U./day), a calf administered a half dose of the V-AD3E premix, and a calf administered only V-A 3,000,000 I.U./day. The remaining calves without Hyena disease were a calf administered only V-D3 300,000 I.U./day and a control calf. Each agent was administered orally for 10 days from 1 week after birth. In the 3 calves with Hyena disease, the bone metabolism in bone histomorphometry of ilium was in the state of low turnover at the age of 50 days. The bone volume was small at the age of 12 months. The epiphysial growth plates of the distal femurs and the proximal tibias partially disappeared and the chondrocyte lacunas in them were flattened. The matrix fibers of epiphysial growth plates were thinner in diameter and higher in density than those of the control calf. In the calf administered only V-D3, the values of bone volume decreased with aging. In conclusion, Hyena disease may be caused by excessive administration of V-A, because hypervitaminosis A suppressed the activity of differentiation and proliferation in chondrocytes and osteoblasts, and excessive administration of V-D3 may promote these actions.

Animals↗

PubMed1983

Traumatic dislocation of the hip in adolescence with separation of the capital epiphysis. Two case reports.

Fracture separation of the capital femoral epiphysis occurring during attempted closed reduction of a traumatic dislocation of the hip is described in two adolescents. Although this complication is extremely rare, the prognosis of fracture separation with dislocation of the epiphysis is known to be poor. Avascular necrosis subsequently developed in both cases. The importance of gentle manipulative reduction under general anaesthesia with complete muscle relaxation is emphasised.

Adolescent↗

PubMed1983

Irreducible fracture-separations of the distal tibial epiphysis.

Three cases of a rare complication of Salter Type II fracture-separations of the distal tibial epiphysis are described. Interposition of the anterior tibial neurovascular bundle between the displaced epiphysis and the lower tibia prevented reduction and, in two patients, the blood supply to the foot was compromised. Open reduction and internal fixation resulted in a satisfactory outcome in each case.

Adolescent↗

PubMed1984

Experimental epiphysial distraction producing and correcting angular deformities.

Angular deformities of the distal radius of 15 sheep were induced by asymmetrical epiphysial distraction. Eleven sheep were between 10 and 20 weeks old; four were older than 24 weeks. Gradual distraction on the medial side of the limb caused partial separation of the epiphysis from the metaphysis, resulting in a valgus deformity. The distraction device was removed three to six weeks after insertion. Spontaneous correction of angulation with growth occurred in the younger sheep; but when the induced valgus angle exceeded 20 degrees correction was poor. In two sheep further distraction was applied on the lateral side and this produced complete correction. Premature closure of epiphyses did not occur after distraction and longitudinal growth of the bone remained normal. In the older sheep asymmetrical distraction succeeded in inducing angulation in only one case, and correction was poor.

Age Factors↗

PubMed1985

Slipped upper femoral epiphysis and primary juvenile hypothyroidism.

The pathogenesis of slipped upper femoral epiphysis is unknown but the condition has been linked with various endocrine disorders. Nine patients with slipped epiphyses in association with primary juvenile hypothyroidism are presented. In all patients, slipping occurred or symptoms developed in the affected hip before the hypothyroidism was diagnosed. A generalised pathology was suggested by the absence of trauma (8 patients), by bilateral slipping (6 patients), and by obesity and short stature in all patients. All cases had delayed skeletal maturation and characteristic metaphysial changes were seen on their radiographs. The clinical diagnosis of juvenile hypothyroidism can be difficult but it merits consideration in patients who have a slipped upper femoral epiphysis in association with short stature, obesity, delay in skeletal maturity, or any one of these.

Adolescent↗