Epiphyseolysis capitis femoris

Zusammenfassung

Die Epiphyseolysis capitis femoris (ECF) bezeichnet die anterolaterale Verschiebung der Metaphyse im Verhältnis zur Femurkopf-Epiphyse und stellt eine der häufigsten Erkrankungen des Hüftgelenkes beim Herangewachsenen dar. Dennoch führt die Verzöge-rung der Diagnosestellung regelmäßig zu einer Verzögerung einer adäquaten operativen Therapie und damit zu vermeidbaren Komplikationen. Bezüglich der Ätiologie werden verschiedene biomechanische, biochemische und genetische Faktoren untersucht. Die Symptome reichen von plötzlicher Geh- und Stehunfähigkeit bis hin zur vollständigen Abwesenheit von Symptomen. Die Klassifikation der ECF kann zeitlich (akut, akut auf chronisch oder chronisch), klinisch (stabil, instabil) und radiomorphologisch (milder, moderater und schwerer Abrutsch) erfolgen. Kurzfristige Folgeschäden einer ECF sind avaskuläre Femurkopfnekrose oder Chondrolyse, mittelund langfristige Folgeschäden sind femoroazetabuläres Impingement (FAI) und Coxarthrose. Die kontralaterale Seite ist im Verlauf in 60–80 % betroffen und wird in Europa typischerweise prophylaktisch mitbehandelt.

Summary

Slipped capital femoral epiphysis (SCFE), the anterolateral displacement of the metaphysis from the proximal femoral physis, is one of the most frequent hip disorders in adolescents. However, a delay in diagnosis often leads to a delay of adequate therapeutic intervention and thus to evitable complications. Concerning etiology, several bio-mechanical, biochemical and genetic factors are under investigation. The clinical presentation ranges from sudden disability of standing and walking to complete lack of symptoms. The classification of SCFE can be temporal (acute, acute on chronic, chronic) clinical (stable, unstable) and radio-morphological (mild, moderate, and severe). Short-term sequelae are avascular necrosis of the epiphysis or chondrolysis, medium- and long-term sequelae are femoroacetabular impingement (FAI) and osteoarthritis of the hip joint. The contralateral side is affected in 60–80% and is treated prophylactically in Europe.

Schlüsselwörter

Epiphyseolysis - Operation - Hüftimpingement - chirurgische Hüftluxation - Hüftgelenk -arthroskopie

Keywords

Epiphyseolysis - operation - hip impingement - surgical dislocation of the hip - hip arthroscopy

• Literatur

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