Read Aloud the Text Content

This audio was created by Woord's Text to Speech service by content creators from all around the world.

Text Content or SSML code:

10 9 8 7 6 5 4 3 2 1 0. This mechanically unfavourable situation can occur secondary to excessive shear forces, a weak growth plate, or both. Important features of the predisposed hip that may be the primary cause of slipped epiphysis are: Predisposing features lije thinning of perichondral ring complex. Retroversion of femoral neck. Change in inclination of proximal femoral physis relative to femoral neck and shaft. Also some associated conditions with mechanical etiology like infantile and adolescent blount disease and patients with peroneal spastic flatfoot and Legg – Calve – Perthes disease. Slipped capital femoral epiphysis is not a single entity but instead is a disease spectrum, ranging from a very mild, primarily asymptomatic, condition that only comes to medical attention later in life to a sudden, severe presentation that requires urgent surgical intervention. We do not know the number of patients with SCFE that never seek medical advice. There is worldwide consensus that SCFE should be treated. T he types and timing of surgical treatment, as well as postoperative protocols, can vary between (and even within) centres and by region worldwide. These differences in management are based on considerations relating to clinical presentations, resources, personal surgical expertise, and preferences. Therefore, it is impossible to establish the true natural history as almost all published series have reported on treated SCFE and the volume of subclinical cases is unknown. Surgical techniques for the treatment of SCFE; including the addition of re-alignment procedures; have evolved significantly over the last 40 years and it would be interesting to see whether the above findings and trends would remain the same with modern surgical techniques. Typically, children affected by SCFE presents complaints of knee, groin, medial thigh or hip pain associated with a limp. Parents and friends may have noticed that the child’s foot points outward. The knee pain which is a referred pain from the obturator nerve often confuses the treating primary clinician and can delay the diagnosis. Acute slips have a more dramatic presentation, with sudden severe pain and inability to walk. Limping and out-toeing gait will be noted on careful clinical examination. The affected leg appears short and externally rotated when patient is lying on their back. In chronic, stable SCFE, obligatory external rotation (positive Drehmann’s sign) is typically present on flexion of the hip. In case of chronic SCFE, hyperextension of hip can be identified on clinical examination. Also, Craig’s test (also known as the prone trochanteric test) would show a retroverted femur. Trendelenburg sign will be positive in chronic slips. When an unstable slip is present, the patient will be unable to bear weight, precluding this test. In equivocal cases, the patient should be advised to be non-weight bearing until the diagnosis of SCFE is ruled out as a subsequent acute event could cause an unstable slip with its associated poorer prognosis. Although rare, endocrine disorders must be considered in any child outside the age range of 10–16 years typical for SCFE and for those less than 50th centile of weight