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Epifisiolisis de cadera

Authors: Gascó Gómez, J.; Sangüesa, M. J.; Castejón, M.;

Epifisiolisis de cadera

Abstract

a epifisiolisis de cadera, aún no siendo una enfermedad muy frecuente, sigue siendo una de las afecciones de la cadera del adolescente que más contribuye al desencadenamiento de la degeneración artrósica. La etiopatogenia es desconocida. Sólo en algunos casos existen alteraciones endocrinas que pudieran alterar la resistencia de la fisis ante fuerzas de carga, la gran mayoría únicamente parecen evidentes factores puramente mecánicos y los recientes estudios anatomopatológicos así lo demuestran. El diagnóstico clínico, en su etapa inicial, sigue siendo la pieza clave para obtener un buen resultado. Por ello se insiste en la aparición de signos radiológicos precoces y que deben confirmarse mediante una adecuada exploración radiográfica. El tratamiento consiste en detener el posible desplazamiento epifisario, lo cual se consigue mediante la fijación de la epífisis, es reservando las osteotomías intra-articulares para los casos con desplazamiento grave. La mejoría en la técnica quirúrgica e indicaciones más precisas, han hecho bajar el porcentaje de complicaciones, en lo que se refiere a la condrolisis y necrosis. Hace falta más investigación para averiguar su etiopatogenia y llegar a conseguir la detección precoz de la enfermedad.

Slipped capital femoral epiphysis is a relative infrequent entity but it is responsible for early degenerative arthritis. The aetiology still remains unknown. Only in a few cases, endocrine factors decreasing the resistance of the physis to shear strength can be detected. In most patients, mechanical factors seem to be implicated, and recent pathological studies have confirmed this hypothesis. At early stages, the clinical diagnosis continues to be essential in order to obtain a good outcome. The detection of radiological findings has been said to be crucial in the first stage of the disease, and therefore an adequate examination should be performed. The goal of treatment is to stop slipping of the femoral epiphysis which can be achieved by internal fixation with techniques. Intraarticular osteotomies should be reserved for cases with great displacement. The improvement of surgical techniques and a more precise indications have contributed to a lower rate of complications such as condrolysis and femoral head necrosis. Understanding of the aetiology and signs for early detection of the disease are demanding further research.

Keywords

Medicina clínica, UNESCO::CIENCIAS MÉDICAS, :CIENCIAS MÉDICAS [UNESCO], Ciencias de la salud

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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