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Epiphysiolysis

Epiphysiolysis Abstract The sharp limitation of the occurrence of slipping of the upper femoral epiphysis to the accelerative phase of the pubertal growth spurt, such variations as occur duplicating strikingly a frequency curve of the time of occurrence of the "year of maximum growth—the MG year"1 (Fig. 1), suggests conditioning of the episode by a metabolic abnormality peculiar to this period. The fact that it occurs most frequently in the overweight child recalls an old observation of a reciprocal relationship between gain in weight and calcium retention2; the more rapidly the growing animal was permitted to gain in weight, the more florid the rickets that resulted from the Steenbock diet. A similar phenomenon is observed when testosterone is administered to the normal boy; marked increase in the retention of nitrogen is accompanied by reciprocal fall in calcium storage.3 It is the thesis of this paper that suboptimal mineralization is References 1. Shuttleworth, F. L.: Sexual Maturation and Physical Growth of Girls Age 6 to 19, Monograph of the Society for Research in Child Development, National Research Council, 1937. 2. Hess, A. F.: Rickets, Including Osteomalacia and Tetany , Philadelphia, Lea & Febiger, 1929, pp. 92-93. 3. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period of Growth: VII. Effect of Methyl Testosterone , Am. J. Dis. Child. 74:52, 1947.Crossref 4. Key, J. A.: Epiphyseal Coxa Vara , J. Bone & Joint Surg. 8:53, 1926. 5. Evans, H. M.; Simpson, M. E.; Marx, W., and Kibrick, E.: The Biopsy of the Pituitary Growth Hormone: Width of the Proximal Epiphyseal Cartilage of the Tibea in Hypophysectomized Rats , Endocrinology 32:355, 1929. 6. Sutro, C. J.: Slipping of the Capital Epiphysis of the Femur in Adolescence , Arch. Surg. 31:345, 1935. 7. Ghormley, R. K., and Fairchild, R. D.: The Diagnosis and Treatment of Slipped Epiphyses , J. A. M. A. 114:229, 1940. 8. Howorth, B.: The Osteochondroses , in Advances in Pediatrics , Vol. 3, edited by E. Z. Levine, Chicago, Year Book Publishers, Inc., 1948, p. 305. 9. LaCroix, P., and Verbrugge, J.: Slipping of the Upper Femoral Epiphysis: A Pathological Study , J. Bone & Joint Surg. 33A:371, 1951. 10. Eliot, M. M., and Park, E. A.: Rickets , in Practice of Pediatrics . J. Brenneman, Editor, Hagerstown, Md., W. F. Prior Co., Ch. 36, 1948. 11. Harris, W. R.: Endocrine Basis for Slipping of Upper Femoral Epiphysis: Experimental Study , J. Bone & Joint Surg. 32B:5, 1950. 12. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period of Growth: VI. The Calcium and Vitamin D Requirements of the Older Child , Am. J. Dis. Child. 67:265, 1944. 13. Stieda, A.: Zur Coxa Vara , Arch. klin. Chi. 63:742, 1901. 14. Johnston, J. A., and Maroney, J. W.: Observations on Nitrogen and Calcium Balances as Affected by Growth and Gonadotropic Hormones Administered for Short Periods to Growing Children , Endocrinology 25:199, 1939. 15. Talbot, N. B.; Sobel, E. H.; McArthur, J. W., and Crawford, J. D.: Functional Endocrinology from Birth Through Adolescence , London, Harvard University Press, 1952, pp. 486-494. 16. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period Growth: IV. Effect of Estrogen , Am. J. Dis. Child. 62:708, 1941. 17. Johnston, J. A., and Maroney, J. W.: Factors Affecting the Retention of Nitrogen and Calcium in the Period of Growth: I. The Effect of Thyroid in Nitrogen Retention , Am. J. Dis. Child. 58:965, 1939. 18. Johnston, J. A., and Maroney, J. W.: Factors Affecting the Retention of Nitrogen and Calcium in the Period of Growth: II. The Effect of Thyroid on Calcium Retention , Am. J. Dis. Child. 58:1186, 1939. 19. Johnston, J. A.: Nutritional Studies in Adolescent Girls and Their Relation to Tuberculosis , Springfield, Ill., Charles C Thomas, Publisher, 1953. 20. Knapp, E. L.: Factors Influencing the Urinary Excretion of Calcium. I. In Normal Persons , J. Clin. Invest. 26:182, 1947. 21. Bullock, J. K.: Physiological Variations in the Inorganic Blood Phosphorus Content at the Different Age Periods: Attempt to Explain These in Growing Child , Am. J. Dis. Child. 40:725, 1930. 22. Howard, J. E.; Parson, W., and Bigham, R. S.: Studies in Patients Convalescent From Fracture: III. The Urinary Excretion of Calcium and Phosphorus , Bull. Johns Hopkins Hosp. 77: 291, 1945. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1956 American Medical Association. All Rights Reserved.
ISSN
0096-6916
DOI
10.1001/archpedi.1956.02060030331003
Publisher site
See Article on Publisher Site

Abstract

Abstract The sharp limitation of the occurrence of slipping of the upper femoral epiphysis to the accelerative phase of the pubertal growth spurt, such variations as occur duplicating strikingly a frequency curve of the time of occurrence of the "year of maximum growth—the MG year"1 (Fig. 1), suggests conditioning of the episode by a metabolic abnormality peculiar to this period. The fact that it occurs most frequently in the overweight child recalls an old observation of a reciprocal relationship between gain in weight and calcium retention2; the more rapidly the growing animal was permitted to gain in weight, the more florid the rickets that resulted from the Steenbock diet. A similar phenomenon is observed when testosterone is administered to the normal boy; marked increase in the retention of nitrogen is accompanied by reciprocal fall in calcium storage.3 It is the thesis of this paper that suboptimal mineralization is References 1. Shuttleworth, F. L.: Sexual Maturation and Physical Growth of Girls Age 6 to 19, Monograph of the Society for Research in Child Development, National Research Council, 1937. 2. Hess, A. F.: Rickets, Including Osteomalacia and Tetany , Philadelphia, Lea & Febiger, 1929, pp. 92-93. 3. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period of Growth: VII. Effect of Methyl Testosterone , Am. J. Dis. Child. 74:52, 1947.Crossref 4. Key, J. A.: Epiphyseal Coxa Vara , J. Bone & Joint Surg. 8:53, 1926. 5. Evans, H. M.; Simpson, M. E.; Marx, W., and Kibrick, E.: The Biopsy of the Pituitary Growth Hormone: Width of the Proximal Epiphyseal Cartilage of the Tibea in Hypophysectomized Rats , Endocrinology 32:355, 1929. 6. Sutro, C. J.: Slipping of the Capital Epiphysis of the Femur in Adolescence , Arch. Surg. 31:345, 1935. 7. Ghormley, R. K., and Fairchild, R. D.: The Diagnosis and Treatment of Slipped Epiphyses , J. A. M. A. 114:229, 1940. 8. Howorth, B.: The Osteochondroses , in Advances in Pediatrics , Vol. 3, edited by E. Z. Levine, Chicago, Year Book Publishers, Inc., 1948, p. 305. 9. LaCroix, P., and Verbrugge, J.: Slipping of the Upper Femoral Epiphysis: A Pathological Study , J. Bone & Joint Surg. 33A:371, 1951. 10. Eliot, M. M., and Park, E. A.: Rickets , in Practice of Pediatrics . J. Brenneman, Editor, Hagerstown, Md., W. F. Prior Co., Ch. 36, 1948. 11. Harris, W. R.: Endocrine Basis for Slipping of Upper Femoral Epiphysis: Experimental Study , J. Bone & Joint Surg. 32B:5, 1950. 12. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period of Growth: VI. The Calcium and Vitamin D Requirements of the Older Child , Am. J. Dis. Child. 67:265, 1944. 13. Stieda, A.: Zur Coxa Vara , Arch. klin. Chi. 63:742, 1901. 14. Johnston, J. A., and Maroney, J. W.: Observations on Nitrogen and Calcium Balances as Affected by Growth and Gonadotropic Hormones Administered for Short Periods to Growing Children , Endocrinology 25:199, 1939. 15. Talbot, N. B.; Sobel, E. H.; McArthur, J. W., and Crawford, J. D.: Functional Endocrinology from Birth Through Adolescence , London, Harvard University Press, 1952, pp. 486-494. 16. Johnston, J. A.: Factors Influencing Retention of Nitrogen and Calcium in Period Growth: IV. Effect of Estrogen , Am. J. Dis. Child. 62:708, 1941. 17. Johnston, J. A., and Maroney, J. W.: Factors Affecting the Retention of Nitrogen and Calcium in the Period of Growth: I. The Effect of Thyroid in Nitrogen Retention , Am. J. Dis. Child. 58:965, 1939. 18. Johnston, J. A., and Maroney, J. W.: Factors Affecting the Retention of Nitrogen and Calcium in the Period of Growth: II. The Effect of Thyroid on Calcium Retention , Am. J. Dis. Child. 58:1186, 1939. 19. Johnston, J. A.: Nutritional Studies in Adolescent Girls and Their Relation to Tuberculosis , Springfield, Ill., Charles C Thomas, Publisher, 1953. 20. Knapp, E. L.: Factors Influencing the Urinary Excretion of Calcium. I. In Normal Persons , J. Clin. Invest. 26:182, 1947. 21. Bullock, J. K.: Physiological Variations in the Inorganic Blood Phosphorus Content at the Different Age Periods: Attempt to Explain These in Growing Child , Am. J. Dis. Child. 40:725, 1930. 22. Howard, J. E.; Parson, W., and Bigham, R. S.: Studies in Patients Convalescent From Fracture: III. The Urinary Excretion of Calcium and Phosphorus , Bull. Johns Hopkins Hosp. 77: 291, 1945.

Journal

A.M.A. Journal of Diseases of ChildrenAmerican Medical Association

Published: Oct 1, 1956

References