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Results for “Epiphyses, Slipped”

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At least 19 recordsLinked to original sources
PubMed1976

[Management of slipped epiphyses in renal osteodystrophy (author's transl)].

Epiphyseal slipping in uraemia differs strikingly from juvenile epiphyseal slipping with respect to pathology and therapy. Based on our own experience with the treatment of 8 uraemic children with epiphyseal slipping, an effort was made to establish the respective indications for conservative and surgical treatment. Mechanical stabilization of slipped epiphyses was achieved within a few weeks without any surgery and usually without parathyreoidectomy by vitamin D3 alone. The initial dose was 10,000 to 30,000 I.U./day, the total curative dose 1.8 to 5.6 millions I.U. Prolonged immobilization was unnecessary. Rising urinary calcium excretion was a valuable indicator of vitamin D intoxication even in advanced renal failure. In one case, pronounced metaphyseal deformations (distal femur, distal tibia) required surgical correction before the ability to walk normally was restored. - The following therapeutical approach is recommended: metabolic bone disease must be cured by vitamin D therapy with or without parathyreoidectomy. Osteotomy to correct metaphyseal deformities or coxa vara epiphysaria never should be performed before metabolic bone disease is healed.

Adolescent↗
PubMed1975

Slipped epiphyses in renal osteodystrophy.

Clinical, biochemical, roentgenological, and histological features of slipped epiphyses (epiphysiolysis) in 11 out of 112 children with renal osteodystrophy have been analysed. Characteristic age-related patterns of involvement of different epiphyses are described. Quantitative measurements of iliac bone histology, serum parathyroid hormone levels, and clinical history show the presence of more advanced osteitis fibrosa in children with epiphysiolysis than in those without. A good correlation was found between serum parathormone levels and osteoclastic resorption, endosteal fibrosis as well as osteoid. Histological studies show that the radiolucent zone between the epiphyseal ossification centre and the metaphysis in x-rays is not caused by accumulation of cartilage and chondro-osteoid (as usually found in vitamin D deficiency rickets) but by the accumulation of woven bone and/or fibrous tissue. The response to vitamin D therapy in most cases was good. Parathyroidectomy was required in only one case.

Adolescent↗
PubMed1992

[Three rare fractures of the radius associated with an ulnar slipped epiphyses].

Over a period of 7 years, three adolescent boys had an associated diaphyseal fracture of the distal third of the radius with separation of the distal ulnar epiphysis. The fracture involved towards early epiphysiodesis of the growth plate of the distal ulna leading to a shortened ulna without any severe functional disability. The mechanisms of injury and complication are described. The treatment of this associated lesion is classical emergency, but the radiological follow-up must be extended in time because the growth potential of the forearm bones is important even during adolescence. The onset of a growth disturbance requires rapid surgical epiphysiodesis of the radius to prevent the development of deformity.

Adolescent↗
PubMed1983

[Fractures and slipped epiphyses of the proximal humerus in children. Place and methods of surgical treatment].

Fractures and Epiphyseal separations of the proximal humerus are usually non-operatively treated with a generally good result. However, sometimes, a surgical treatment may be required. Twenty fractures of the proximal humerus occurring in children were treated operatively. From these 20 cases, the authors precise the indications and the ways of surgical treatment in this type of lesion. They insist upon the value of the angulation on the lateral radiograph of the shoulder which, if important, may often signify an interposition of the tendon of the long head of the biceps between the fracture fragments causing irreductibility; they propose a classification of the fractures referring to this angle. Considering surgical procedure, delto-pectoral approach is the most commonly used, although axillary way is more esthaetic. Kirschner wires and screws are the best means of synthesis. Anyway, this surgical treatment has to remain exceptional.

Bone Nails↗
PubMed1983

[Dislocated supracondylar femoral fractures, slipped epiphyses and epiphyseal fractures in children].

Dislocated supracondylar femoral fractures are usually transverse fractures and are unstable. In our opinion the primary treatment of these fractures should be surgical in order to save the patient a protracted healing period. Osteosynthesis using a straight plate is impossible, as the distal fragment is too short. Condylar plates are contraindicated and angular plates have too little stability. We feel that intramedullary pins are unsuitable in children. They provide too little stability when the distal fragment is short. Up to now we have achieved the best results with external fixation. Slipped epiphyses and epiphyseal fractures do not present problems as far as the surgical procedure is concerned (removal of the displaced periosteum, repositioning and compression). Healing is not delayed. The long-term results are poor, however, due to premature closure of the damaged epiphyseal plate.

Adolescent↗