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J Child Orthop. 2015 Feb;9(1):1-8. doi: 10.1007/s11832-014-0630-z. Epub 2015 Jan 11.

Hegemann's disease and fishtail deformity: aetiopathogenesis, radiographic appearance and clinical outcome.

Journal of children's orthopaedics

Femke M A P Claessen, Jan K G Louwerens, Job N Doornberg, C Niek van Dijk, Michel P J van den Bekerom, Denise Eygendaal

Affiliations

  1. Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School and University of Amsterdam Medical School, Boston, MA, USA, [email protected].

PMID: 25577162 PMCID: PMC4340852 DOI: 10.1007/s11832-014-0630-z

Abstract

PURPOSE: A systematic review regarding clinical studies on Hegemann's disease and fishtail deformity was performed with the aims to: (1) formulate the most up-to-date theory on aetiology in order to better define these conditions, (2) summarise the most frequent radiographic descriptions on radiographs and (3) give an overview of different treatment options.

METHODS: A systematic review of studies to date on Hegemann's disease and fishtail deformity was performed. Studies were eligible if: (1) the article provides a description of Hegemann's disease or fishtail deformity, (2) original data of at least one patient was available, (3) the article was written in English, German or Dutch and (4) a full manuscript was available. Animal studies, reviews and expert opinions were not included.

RESULTS: We included a total of 22 articles: seven regarding Hegemann's disease including eight patients and 15 regarding fishtail deformity including 58 patients.

CONCLUSIONS: Fishtail deformity and Hegemann's disease seem to be a spectrum of vascular disorders of the distal humerus, varying from a benign mild vascular disorder to a complete avascular necrosis after fractures. Additional imaging is advised to confirm the presence of a fishtail deformity, intra-articular loose bodies and signs of osteoarthritis to decide if, and what, operative treatment is needed. As long as no clear aetiology for both diseases exist and the clinical symptoms and radiographic appearance are difficult to distinguish, both entities should preferably be named as 'vascular disturbance of the trochlear growth plate' to overcome confusing definitions and discussions.

References

  1. Clin Orthop Relat Res. 1977;(127):161-3 - PubMed
  2. J Pediatr Orthop. 2004 Mar-Apr;24(2):201-4 - PubMed
  3. Arch Orthop Unfallchir. 1971;70(4):340-3 - PubMed
  4. J Bone Joint Surg Am. 1948 Apr;30A(2):347-58 - PubMed
  5. J Pediatr Orthop. 2013 Sep;33(6):592-7 - PubMed
  6. J Pediatr Orthop. 2012 Dec;32(8):e57-62 - PubMed
  7. Ann Chir Gynaecol Fenn. 1964;53:156-9 - PubMed
  8. J Pediatr Orthop. 2007 Jul-Aug;27(5):547-50 - PubMed
  9. J Bone Joint Surg Br. 1975 Nov;57(4):430-6 - PubMed
  10. Radiologe. 1981 Apr;21(4):165-74 - PubMed
  11. J Bone Joint Surg Am. 1985 Jul;67(6):851-6 - PubMed
  12. Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1101-5 - PubMed
  13. Acta Orthop Scand Suppl. 1959;38:1-232 - PubMed
  14. J Pediatr Orthop B. 2000 Oct;9(4):309-18 - PubMed
  15. Chir Organi Mov. 1993 Apr-Jun;78(2):105-9 - PubMed
  16. Unfallchirurg. 1998 Apr;101(4):280-6 - PubMed
  17. J Bone Joint Surg Br. 1964 Feb;46:46-9 - PubMed
  18. Cochrane Database Syst Rev. 2004 Oct 18;(4):CD002924 - PubMed
  19. Rinsho Hoshasen. 1965 Feb;10:172-3 - PubMed
  20. Fortschr Geb Rontgenstr. 1951 Jul;75(1):89-92 - PubMed
  21. J Med Imaging Radiat Oncol. 2010 Oct;54(5):450-6 - PubMed
  22. Arch Orthop Trauma Surg. 1990;110(1):45-8 - PubMed
  23. Emerg Med J. 2014 May;31(5):380-3 - PubMed
  24. Z Unfallchir Versicherungsmed. 1990;83(1):49-53 - PubMed
  25. Emerg Radiol. 2011 Dec;18(6):507-11 - PubMed
  26. Skeletal Radiol. 2009 May;38(5):479-91 - PubMed
  27. Acta Orthop Belg. 2009 Jun;75(3):408-10 - PubMed
  28. J Pediatr Orthop B. 2001 Apr;10 (2):142-52 - PubMed
  29. Beitr Orthop Traumatol. 1984 May;31(5):261-7 - PubMed

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