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The epiphyseal tubercle in adolescent hips
1Dept of Orthopaedics, Royal Gwent Hospital, Newport, South Wales, UK. keithtayton@hotmail.com
Acta Orthopaedica
|July 24, 2009
Summary
The epiphyseal tubercle significantly restrains adolescent femoral epiphysis slippage. This anatomical feature, visualized well with CT scanography, prevents shearing displacement in the hip.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Human anatomy
Background:
- Chronic slippage of the adolescent upper (capital) femoral epiphysis is generally considered unlikely due to shearing forces.
- Anatomical studies suggest an epiphyseal tubercle projecting into the metaphysis plays a role in preventing slippage.
- The in vivo presence and effect of this tubercle remain largely undescribed in medical literature.
Purpose of the Study:
- To investigate the in vivo presence and size of the epiphyseal tubercle in adolescents.
- To evaluate the restraining effect of the epiphyseal tubercle on femoral epiphysis position.
- To determine the optimal imaging modality for visualizing this anatomical feature.
Main Methods:
- Analysis of plain radiographs from 20 adolescent patients.
- CT scans were performed on 9 of these adolescents.
- Radiographs and CT scans were assessed for the epiphyseal tubercle's size and presence.
Main Results:
- CT scanography proved to be the investigation of choice for illustrating the epiphyseal tubercle.
- The tubercle was well-visualized in vivo, in anatomical position, and during stages of epiphyseal slippage.
- Evidence confirmed a significant restraining effect of the tubercle on the epiphysis's positional stability relative to the metaphysis.
Conclusions:
- The epiphyseal tubercle is a significant anatomical feature in adolescents that restrains capital femoral epiphysis displacement.
- CT scanography is highly effective for visualizing this tubercle and its role in preventing slippage.
- Findings support the tubercle's mechanical role in preventing shearing of the adolescent femoral epiphysis.
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