THE EPIDEMIOLOGY OF BILATERAL SLIPPED CAPITAL FEMORAL EPIPHYSIS - A STUDY OF CHILDREN IN MICHIGAN
THE EPIDEMIOLOGY OF BILATERAL SLIPPED CAPITAL FEMORAL EPIPHYSIS - A STUDY OF CHILDREN IN MICHIGAN
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DOI：
10.2106/00004623-199308000-00003
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发表时间：
1993-08-01
影响因子：
5.3
通讯作者：
GREENFIELD, ML
中科院分区：
文献类型：
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作者：
LODER, RT;ARONSON, DD;GREENFIELD, ML
回顾性研究了224例儿童股骨头骨骺滑脱的记录，这些儿童没有潜在的代谢或内分泌紊乱，以调查双侧股骨头骨骺滑脱的流行病学。在224名儿童中，有82名（37%）（51名男孩和31名女孩）有双侧滑脱。这些儿童中有64名是黑人，18名是白色，第一次诊断时的年龄为13 ± 1.7岁（平均值和标准差），症状持续时间为5 ± 5.0个月，滑动角度为26 ± 16度。肥胖儿童在诊断首次滑脱时年龄较小（12 ± 1.6岁，而非肥胖儿童为13 ± 1.6岁，p = 0.001）。41名儿童的双侧髋关节同时诊断为股骨头骨骺滑脱，41名儿童的双侧髋关节依次诊断为股骨头骨骺滑脱。与两髋同时诊断的儿童相比，髋关节顺序诊断的儿童在第一次滑倒诊断前症状持续时间较短（3 +/- 2.4与7 +/- 5.9个月相比，p = 0.0003），在第一次诊断时年龄更小（12 +/- 1.9岁与13 +/- 1.2岁相比，p = 0.001），并且倾向于更肥胖（p +/- 0.025）。在88%的连续性滑倒的患者中，第二次滑脱是在第一次滑脱诊断后18个月内诊断出来的。单侧滑脱且随后发生对侧髋关节滑脱的儿童在第一次滑脱诊断时比未发生对侧髋关节滑脱的儿童更年轻（12 +/- 1.9与13 +/- 1.6年相比，p = 0.002）。我们建议在诊断为单侧滑脱后的前两年进行频繁的随访检查，特别是如果患者是十二岁或更小的女孩或十四岁或更小的男孩。滑动，应继续随访，直到有明确的影像学证据显示两侧髋关节骨骺闭合。
The records of 224 children who had a slipped capital femoral epiphysis and who had no underlying metabolic or endocrine disorder were studied retrospectively to investigate the epidemiology of bilateral slipped capital femoral epiphysis. Eighty-two (37 per cent) of the 224 children (fifty-one boys and thirty-one girls) had a bilateral slip. Sixty-four of these children were black and eighteen were white.The age at the time of the diagnosis of the first slip was 13 +/- 1.7 years (mean and standard deviation), the duration of the symptoms was 5 +/- 5.0 months, and the angle of the slip was 26 +/- 16 degrees. Obese children were younger at the time of the diagnosis of the first slip (12 +/- 1.6 compared with 13 +/- 1.6 years for the children who were not obese, p = 0.001).The diagnosis of a slipped capital femoral epiphysis was made simultaneously in both hips in forty-one children and sequentially in forty-one children. Compared with the children in whom both hips were diagnosed simultaneously, the children in whom the hips were diagnosed sequentially had had a shorter duration of the symptoms before the diagnosis of the first slip (3 +/- 2.4 compared with 7 +/- 5.9 months, p = 0.0003), were younger at the time of the diagnosis of the first slip (12 +/- 1.9 compared with 13 +/- 1.2 years, p = 0.001), and tended to be more obese (p +/- 0.025). In 88 per cent of the patients who had sequential slips, the second slip was diagnosed within eighteen months after the diagnosis of the first slip.The children who had a unilateral slip and in whom a slip of the contralateral hip developed subsequently were younger at the time of the diagnosis of the first slip than those in whom a contralateral slip did not develop (12 +/- 1.9 compared with 13 +/- 1.6 years, p = 0.002).We recommend frequent follow-up examinations for the first two years after the diagnosis of a unilateral slip, especially if the patient is a girl who is twelve years old or less or a boy who is fourteen years old or less. In order to prevent a delay in the diagnosis of a second slip, follow-up should continue until there is definite radiographic evidence of physeal closure in both hips.