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Slipped capital femoral epiphysis in an adult with panhypopituitarism.

机译:患有泛垂体功能低下的成年人的股骨骨epi滑倒。

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摘要

Slipped capital femoral epiphysis usually occurs in children going through a pubertal growth spurt, possibly because the immature proximal femoral physis is unable to bear the shear stress. It commonly occurs in adolescents between 10 and 16 years. Slipped capital femoral epiphysis in adults is uncommon, with only 10 cases reported in the literature. This article presents a case of a 29-year-old man with craniopharyngioma diagnosed when he was 19. He underwent surgery with subtotal tumor excision and postoperative radiotherapy, but received no further treatment for the panhypopituitarism concomitant with the tumor. He reported sudden onset of left hip pain after riding a bicycle and underwent surgical fixation 5 days later. He also underwent hormone replacement therapy, including prednisolone, thyroxin, desmopressin, and testosterone, and regular clinical follow-up. His hip function recovered with a painless gait. At 18-month follow-up, neither osteonecrosis nor contralateral slipped capital femoral epiphysis was noted. Furthermore, bilateral proximal femoral physes were also closed. For stable slippage as in this case, in situ pinning fixation is a commendable method. A high index of suspicion of endocrinal disorder and proper management are essential for successful treatment of adult slipped capital femoral epiphysis.
机译:股骨骨epi滑倒通常发生在经历青春期突增的儿童中,这可能是因为未成熟的股骨近端骨不能承受剪切应力。它通常发生在10至16岁的青少年中。成人股骨骨capital滑倒的情况并不常见,文献中仅报道了10例。本文介绍了一名29岁的男子,他在19岁时被诊断出患有颅咽管瘤的病例。他接受了次全切除术和术后放疗的手术,但未对伴随该肿瘤的全垂体功能减退进行进一步治疗。他报告骑自行车并在5天后接受手术固定后突然出现左髋疼痛。他还接受了激素替代疗法,包括泼尼松龙,甲状腺素,去氨加压素和睾丸激素,并定期进行临床随访。步态无痛,髋关节功能恢复。在18个月的随访中,未发现骨坏死或对侧滑动的股骨骨epi。此外,双侧股骨近端也被关闭。对于这种情况下的稳定滑动,原位固定是值得推荐的方法。对成功治疗成人滑脱型股骨epi骨症,高度怀疑内分泌失调和适当的治疗至关重要。

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