femur Flashcards
name the (2) conditions of the femur
Legg-Calve-Perthes disease (“Perthes”)
SUFE: slipped upper femoral epiphysis
what is perthes
idiopathic juvenile avascular necrosis of HOF. usually leads to a widening and flattening of HOF
outline the 3 stages of perthes
blood supply disturbed
softening and collapse of bone
re-establishement of blood supply + repair + remodelling of HOF
what age and gender range is perthes most common in ?
4-10 y/o:
M>F
4 or 5:1
what sx. will a patient with perthes present with?
pain at groin or ant HJ or greater troch
or med knee
what signs will a pt with perthes present with?
↓med rotation ↓ abd ↓ ROM \+ve trandelenburg shortening of limb (telescope knees)
treatment for perthes
monitor + analgaesics
slings and casting
surgery (to encourage spherical moulding of HOF)
what is SUFE
slipped upper femoral epiphysis
NOF and shaft displace upwards and anteriorly (think of an icecream scoop falling off of a cone)
what is the typical age that these cases present for M and F
M: 13.5 yrs
F: 12 yrs
what are some signs of SUFE
antalgic gait ~50% of pts will be overweight out toeing shortening of affected limb when you try to flex their hip (pt supine) their thigh will automatically lat rotate
describe sx/signs of acute SUFE
sudden onset of pain (# like description)
refuse to mobilise
unable to WB
describe the sx/signs of chronic SUFE
groin pain + radiating to anteromedial thigh + med KJ
antalgic limp
pain for >3 weeks
no sudden exacerbation
3 weeks after acute phase is when we see this
outline the rx for SUFE
prompt dx and rx
immobilise. completely NWB (Stretcher/wheelchair)
send to hospy for surgery
outline some complications of SUFE
osteonecrosis
chondrolysis (cartilage destroyed)
OA
femoral acetabular impingement due to risk of deformity of NOF after stabilisation and healing
