During the last decade the important role of ultrasound in the study of congenital and acquired diseases in Paediatric Orthopaedics is all the more established and reinforced. The early diagnosis and management of hip disorders during the neonatal period, is of great importance. In this period the skeleton is mostly cartilagenous and can be imaged better and more accurately with the use of ultrasound compared to radiography. Moreover, during growth, diseases, such as transient synovitis of the hip, are imaged better by ultrasound than radiologically. In a two year period 2001–2002 ultrasound examination was used in 990 children which presented clinical findings of suspected hip disease, either congenital (mostly DDH), or acquired, such as transient synovitis, Perthes, SCFE and others. Furthermore, of great interest was one rare case of deep venous thrombosis, in a 13-year old girl. The last was diagnosed by ultrasound. In all cases, significant help was provided to the clinical doctor and important information was derived, regarding the differential diagnosis and management. The quality of imaging and evaluation of the ultrasound findings is fundamental for the successful application of the method. The above requirements are established by the experience and scientific sufficiency of the doctor performing the examination.
The purpose of this paper is the overview of 92 cases with slipped capital femoral epiphysis (S.C.F.E.), treated in inic within the last 18 years (1985–2003).The paper reports the method of treatment and early complications concerning ischaemic necrosis and chondrolysis. During this time, 80 children with S.C.F.E. aged 10–14 years, were treated in our clinic.Of our patients, 50 were boys and 30 girls.With regard to the degree of the slippage, 59 cases 1st degree, 32 were 2nd degree and 1 was 3rd degree;as regards the type, 63 cases were chronic, 17 acute and 12 chronicacute.They were treated surgically by pinning (use of 2 or 3 Moore-Knowls, Steinmann pins and cannulated screws) while in one case osteotomy of the femoral neck was performed.In 11 cases with 2nd degree slippage, total or partial reduction took place on the surgical table,with mild traction and strong internal rotation of the limb.In addition, in 20 cases cannulation was performed. There has been a follow-up period of 1–10 years after surgery. Complications: In 11 hips (in most of which Steinmann pins had been used) occurred slippage of the material inside the joint and the pin was removed (within 2 weeks).During follow-up no signs of either vascular necrosis or chondrolysis were present, with the exception of one case with 2nd degree S.C.F.E. where reduction was also attempted. In total, 2 cases of chondrolysis occurred, in one of which signs of chondrolysis were present even before surgery, and 2 cases of vascular necrosis.The results were evaluated on clinical criteria (limping, pain, reduction in length, range of movement of hip joint) and radiological criteria (articular space, appearance of the femoral head, neck-femoral angle).
