ABSTRACT
Three young people, a boy aged 15 years and two girls aged 9 years and 13 years, had already suffered groin pain and knee pain for many months. They exhibited an antalgic walk, diminished function of the hip and radiographic signs of a slipped capital femoral epiphysis (SCFE). The complaints disappeared following in situ fixation with one or more screws. Epiphysiolysis of the caput femoris through the growth plate is a disorder of the growing hip. It is the most prevalent hip disease in adolescents. Obese boys are the most commonly affected. The aetiology is not known. The later SCFE is diagnosed and treated, the greater the chance of premature coxarthrosis. Avascular necrosis and chondrolysis are complications that can arise as a result of the operation.
Subject(s)
Epiphyses, Slipped/diagnosis , Gait , Hip Dislocation/diagnostic imaging , Hip Joint/pathology , Orthopedic Procedures/adverse effects , Pain/etiology , Adolescent , Bone Screws , Child , Chronic Disease , Epiphyses, Slipped/diagnostic imaging , Epiphyses, Slipped/surgery , Female , Femur Head Necrosis/etiology , Groin , Hip Joint/diagnostic imaging , Hip Joint/surgery , Humans , Knee , Male , Osteoarthritis, Hip/etiology , Prognosis , Radiography , Treatment OutcomeABSTRACT
The apex of human vertebro-basilar junctions can be sharp-edged or blunted. In the present study, the effect of blunted apex on the flow in vertebro-basilar junction models is investigated. We compared the flow phenomena in a series of junction models with blunted apices and confluence angles 45, 85, and 125 deg with the flow phenomena in a series of junction models with sharp-edged apices and the same range of confluence angles, studied in a previous paper (Ravensbergen et al., 1996b). The blunting of the apex appears to have an effect on the size of the local recirculation area near the apex and the prevailing low velocities. Large recirculation areas are found in the models with blunted apices, especially in those with small confluence angles. In addition, the blunting of the apex has no influence on the flow further downstream, nor on the structure and strength of the secondary flow field. Furthermore, a blunted apex appears to be a geometric risk factor for atherosclerosis. This supports the hypotheses that recirculation areas and low wall shear stress influence the development of atherosclerotic plaques.
