The weakest part ofthe epiphysial plate is the layer ofcartilage cells nearest the metaphysis. If the overlying periosteum is incised, a separation through this layer is easily produced (Haas 1917). Even if it is conceded, as shown experimentally by Harris (1950), that, in rats treated by growth hormone, broadening of this layer can diminish the cohesion of epiphysis and metaphysis, the resista...

Two hundred and fourteen cases ofslipped upper femoral epiphysis were reviewed. Fourteen families provided more than one case, and in 23 other families the index case had one or more close relatives with osteoarthritis of the hip, six of whom had probably suffered from a slipped epiphysis. The mode of inheritance is discussed and is thought to be an autosomal dominant with variable penetrance i...

Fracture separation of the capital femoral epiphysis occurring during attempted closed reduction of a traumatic dislocation of the hip is described in two adolescents. Although this complication is extremely rare, the prognosis of fracture separation with dislocation of the epiphysis is known to be poor. Avascular necrosis subsequently developed in both cases. The importance of gentle manipulat...

BACKGROUND Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666-679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI) [Leunig M, Slon...

A 6-year-old boy presented with the recent development of a right sided limp. He had no known medical conditions. On examination, the patient had limited internal/external rotation and abduction of the right hip. He walked with a non-antalgic gait and was noted to have a positive Trendelenberg sign. Lower extremity radiographs (A) revealed flattening of the right proximal femoral epiphysis with...

PURPOSE The purpose of our study was to investigate the histological, histochemical and ultrastructural aspects of the proximal femoral growth plate in slipped capital femoral epiphysis (SCFE). METHODS Eight core biopsies of the proximal femoral growth plate were performed during in situ epiphysiodesis in patients with SCFE that was at the pre-slipping stage in two cases and at the mild slipp...

BACKGROUND The human femur is commonly considered as a subsystem of the locomotor apparatus with four conspicuous levels of organization. This phenomenon is the result of the evolution of the locomotor apparatus, which encompasses both constitutional and individual variability. The work therein reported, therefore, underlies the significance of observing anatomical system analysis of the proxim...