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Slipped Femoral Epiphysis

There is a wide range of different effects resulting from obesity which can affect the physical well-being of both adults and children. Key examples of obesity-related health conditions include gallbladder disease, heart disease, type2 diabetes and slipped femoral epiphysis. The latter condition is associated with the position of the ball in the hip joint moving and thus causing significant pain for those affected.

slipped femoral epiphysis

Understanding Slipped Femoral Epiphysis

Slipped femoral epiphysis is a health condition arising from carrying excessive amounts of weight, with boys between the ages of ten and 16 being the most likely to be affected. The condition is caused by weakness of the joint between the thigh bone and ball joint, allowing the ball to slip and resulting in the child's leg appearing bowed. Chronic femoral epiphysis may also occur when the slip develops at a slower rate. This typically results in children suffering from post-exercise pain in the groin area (which dissipates following a period of rest) and may even cause a limp or result in one leg becoming shorter than the other.

A sudden acute slip is far more rare and usually results in the child suffering from a high level of pain and finding it rather difficult to even walk. This is normally caused by a gradual weakening of the ball joint and children may also complain of having knee pain due to the nerves supplying the knee being the same as those supplying the hip joint.

How Childhood Obesity Affects Femoral Epiphysis

Obesity is directly linked to the condition of slipped femoral epiphysis because these slips or weakening within the ball of the hip joint stem from too much stress being placed upon them. This high level of stress on the joint is identified as being caused by the excessive amount of weight children who are suffering from obesity have on their small frame. In addition, as the joint is not designed to bear such a heavy load, the growth plate eventually becomes considerably weakened and typically requiring specialist treatment.

As a result of this direct link to obesity, it is crucial for parents to encourage overweight children to become more active and alter their dietary intake in order to avoid the likelihood of them suffering from this painful condition or indeed many other forms of obesity-related illness.

Treatment for Slipped Femoral Epiphysis

Slipped femoral epiphysis usually requires children to be admitted into hospital for treatment, which involves being in traction, weights and normally surgical procedures. As any form of surgery is more dangerous when performed on an obese person, there are added risks involved which must be understood. Surgery is often minor and involves the epiphysis being pinned whilst under general anaesthetic with a few small incisions. However, in more severe cases where the joint and plate has become greatly deformed the surgery may take considerably longer and involve a larger incision thus increasing any risks.

Children will usually remain in hospital for around one week post-surgery and then spend up to six weeks on crutches. Following discharge, regular appointments including X-rays will typically be necessary whilst the child is still growing.

As highlighted above, slipped femoral epiphysis involves the ball of the hip joint moving out of place causing significant pain as a result of the body struggling to carry the stress of excess weight, The condition usually requires surgery and is most common in boys of secondary school age.

Source

:
Heaton-Harris, N. (2009) Childrens Health - Combating Obesity Brighton: Emerald Publishing

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Ankle Sprains

ankle sprains

The ankle is a complex joint which allows the foot to perform a number of movements. It is connected to the foot bones by a number of ligaments at the sides and back of the joint. While these ligaments are normally very strong, extreme stretching or awkward movements can lead to injury of the ligaments.

Ankle Injuries – Some of the More Common Causes

The ankle is a rather mobile, flexible joint, however there are certain factors that increase the likelihood of a ligament injury:
  • walking on uneven surfaces
  • sudden twisting movement
  • playing sports – especially jumping and landing awkwardly
  • weak ankle muscles – not strong enough to protect the ankle
  • previous ankle sprains, particularly if the treatment or rehabilitation was inadequate
When a ligament injury of the ankle does occur, it can generally be classified into one of three grades of severity, depending on the extent of ligament damage and associated symptoms.

Grade 1 Ankle Ligament Injury – Minimal Damage

This type of injury means there has been some stretching or minor tearing of the ligament(s). The symptoms include pain, swelling, possibly some ankle joint stiffness but not much functional loss. In other words, despite the pain and swelling, a person can still weight-bear and mobilise – though with some difficulty.

Treatment of mild ligament damage is by resting the foot. The less weight-bearing on the affected foot, the better. Applying an ice pack, compression bandage and elevating the foot above heart level are also very important.

Grade 2 Ankle Sprains – Moderate Ligament Injury

In this type of injury, there is a more severe tearing of the ligament. The symptoms of Grade 2 sprains are more intense – there is usually significantly more swelling and a great deal of pain. The ankle joint becomes rather stiff and range of movement is very limited. The stability of the ankle joint is also compromised.

As with Grade 1 ankle sprains, it is very important to rest the foot. Weight bearing should be avoided completely, if possible. Elevating the affected ankle above heart level, using a compression bandage and regular application of an ice pack are also essential.


Depending on the intensity of the symptoms, anti-inflammatory medication may be indicated.

Following the acute phase of the injury, rehabilitation is highly recommended in order to strengthen the ankle and restore good movement and balance.

Grade 3 Ankle Ligament Tear – Severe Ankle Injury That Requires Medical Treatment

This is the most severe of the three types of ankle ligament injuries, due to a complete rupture of the ligament. Symptoms include severe swelling and pain, gross instability of the ankle and consequently a loss of ankle function.

Treatment of this type of injury often requires surgical intervention, in order to repair the ruptured ligament. Immobilisation of the ankle in a cast is also needed, usually for around two to three weeks and the injured person could be on crutches for several weeks.

Surgery and/or immobilization of the ankle is usually followed by physiotherapy. Rehabilitation is crucial to restore the joint to its pre-injury function and to prevent any future ankle injuries.

Recovery Timeframes for Ankle Sprains Vary According to Severity of the Injury

Recovery from a Grade 1 ankle sprain is fairly quick. Depending on the extent of swelling, full recovery can be achieved within a week or two.

Grade 2 ankle sprains take four to six weeks to heal. This timeframe includes the resting of the ankle in the acute phase of the injury, as well as the subsequent rehabilitation phase. Timely treatment and adequate rehabilitation will generally reduce the recovery timeframe for Grade 2 ankle sprains.

Grade 3 sprains will take longest to heal with eight to 12 weeks being the average timeframe to full recovery. Following medical advice is very important and as mentioned before, rehabilitation is of utmost importance. Failure to treat and rehabilitate a severe ankle sprain will not only increase recovery timeframes, but will almost certainly lead to ongoing ankle problems, such as recurring injuries, pain, swelling, stiffness and poor balance.

Ankle sprains can vary in severity from Grade 1 to Grade 3, but regardless of the severity of the injury, treatment within the first 48 hours will reduce the acute symptoms and will speed up recovery.
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