In line with its mission, the Editorial Board of MedTvoiLokony makes every effort to provide reliable medical content supported by the latest scientific knowledge. The additional flag “Checked Content” indicates that the article has been reviewed by or written directly by a physician. This two-step verification: a medical journalist and a doctor allows us to provide the highest quality content in line with current medical knowledge.
Our commitment in this area has been appreciated, among others, by by the Association of Journalists for Health, which awarded the Editorial Board of MedTvoiLokony with the honorary title of the Great Educator.
In this disease, the head of the femur loses its connection with the neck and slips in the layer of cells overgrowing the epiphyseal cartilage. The head moves back and down in relation to the femoral neck.
The causes of this disease are not fully understood, most lean towards the theory of hormonal disorders. It occurs in adolescents before or during puberty, ie 10–16. years of age, twice as often in boys as in girls, it may occur unilaterally, but more often bilaterally.
It comes in two forms – chronic type (approx. 95%) and acute type (5%).
Chronic form it is characterized by a slow, gradually progressive slide of the head, which with its entire base lies against the neck. In the period preceding exfoliation, slight pains in the hip or knee, sometimes limping, and limited hip movement are characteristic. As soon as exfoliation begins, pain increases, limping increases, and the limb begins to position itself in external rotation. There is a shortening of the limb. The blood supply to the head is preserved.
Acute form it is relatively rare and is characterized by a sudden painful dislocation of the femoral head in an apparently healthy person. The head suddenly separates from the neck in a layer of cells overgrowing the cartilage and significantly dislocates.
The synovial membrane covering the cervix with the vessels running in it are ruptured. The blood supply to the head is impaired. With further displacement, all head vasculature may be damaged, leading to secondary necrosis of the femoral head. The clinical picture of the patient with acute exfoliation largely resembles a fracture of the neck of the femur. There is severe pain, the limb is added, turned outwards and shortened. The patient requires immediate hospital treatment.
Treatment
Due to the duration of the disease process on average 2–3 years and the possibility of a progressive slide before the end of the union and the accompanying numerous complications, the treatment of choice is surgery.
The most serious complications include necrosis of the femur and necrosis of the articular cartilage. In the event of such complications, it is necessary to relieve the limb for several years, which only in some patients can protect the hip joint from complete stiffening. Late complications are degenerative-deforming changes of the hip joint. In the case of unilateral exfoliation, the second hip should be constantly monitored, because exfoliation of the second hip may occur with a delay of several months or years.
The content of the medTvoiLokony website is intended to improve, not replace, the contact between the Website User and their doctor. The website is intended for informational and educational purposes only. Before following the specialist knowledge, in particular medical advice, contained on our Website, you must consult a doctor. The Administrator does not bear any consequences resulting from the use of information contained on the Website.