0
Case Reports   |    
Anterior Slip of the Capital Femoral EpiphysisA Case Report
Mikito Sasaki, MD1; Satoshi Nagoya, MD1; Mitsunori Kaya, MD1; Toshihiko Yamashita, MD1
1 Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S-1 W-16, Chuo-ku, Sapporo 060-8543, Hokkaido, Japan. E-mail address for M. Kaya: mkaya@sapmed.ac.jp
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Investigation performed at the Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Apr 01;89(4):855-858. doi: 10.2106/JBJS.F.00322
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Extract

Slipped capital femoral epiphysis is a well-known disorder of the hip in adolescents. In general, the direction of slip of the capital femoral epiphysis on the femoral neck is posterior and inferior, although superior slips have been reported1,2. We report a case of slipped capital femoral epiphysis in which the epiphysis was displaced anteriorly in relation to the neck. The patient and her family were informed that data concerning the case would be submitted for publication.
Figures in this Article

    First Page Preview

    View Large
    />
    First page PDF preview
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Charbel Daoud Moussallem
    Posted on October 25, 2007
    Coxa Vara, another diagnosis.
    Lebanese University, Faculty of Medical Sciences

    To The Editor:

    I read with interest the case report by Sasaki et al.(1)concerning a patient with a diagnosis of anterior slip of the capital femoral epiphysis and I congratulate them for achieving an excellent surgical outcome.

    However, I do not totally agree with the initial diagnosis. On the plain X-ray of the pelvis, the femoral neck-shaft angle on the affected side is less when compared to the controlateral hip. The computed tomography scan shows a sclerotic metaphysis in the region of the femoral neck, and a slight widening of the physis that does not seem of sufficient magnitude to be associated with a slip.

    I would suggest an alternative diagnosis of primary or secondary femoral neck deformity ie. coxa vara, especially since the Hilgenreiner-epiphyseal angle is more than 25 degrees. A change of the loading characteristics from shear to compressive forces of the femoral neck could explain the slight widening of the physis.

    The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of his immediate family, is affiliated or associated .

    Reference:

    1. Mikito Sasaki, Satoshi Nagoya, Mitsunori Kaya, and Toshihiko Yamashita. Anterior Slip of the Capital Femoral Epiphysis. A Case Report. J Bone Joint Surg Am 2007;89:855-858

    Amanda Hawkins
    Posted on July 10, 2007
    Wrong diagnosis
    Consultant, Dumfries, SCOTLAND

    To The Editor:

    I read with interest the case report on anterior slip of the capital femoral epiphysis(1) but I disagree with the diagnosis. With reference to the plain radiographs, the problem is clearly in the femoral neck and not at the physis. The CT cuts confirm that the problem is metaphyseal. There is no disruption at the physeal plate but there are large amounts of sclerosis at the femoral neck consistent with a chronic problem in the metaphyseal area.

    I would be very interested to have the authors respond and to see if others agree with my observations.

    The author did not receive any outside funding or grants in support of her research for or preparation of this work. Neither she nor a member of her immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the author, or a member of her immediate family, is affiliated or associated.

    Reference:

    1. Mikito Sasaki, Satoshi Nagoya, Mitsunori Kaya, and Toshihiko Yamashita. Anterior Slip of the Capital Femoral Epiphysis. A Case Report J Bone Joint Surg Am 2007; 89: 855-858

    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    12/31/2013
    S. Carolina - Department of Orthopaedic Surgery Medical Univerity of South Carlonina
    04/02/2014
    W. Virginia - Charleston Area Medical Center
    12/04/2013
    New York - Icahn School of Medicine at Mount Sinai
    02/28/2014
    District of Columbia (DC) - Children's National Medical Center