Simultaneous biplanar fluoroscopy for the surgical treatment of slipped capital femoral epiphysis

J Pediatr Orthop. 2008 Jan-Feb;28(1):43-8. doi: 10.1097/BPO.0b013e3181558bee.

Abstract

Background: The current standard of care for treatment of slipped capital femoral epiphysis (SCFE) is in situ placement of a single, cannulated screw across the physis under direct fluoroscopic guidance. Previous studies have reported the theoretical advantages of shorter operative time and improved accuracy of screw placement when 2 fluoroscopy units are used simultaneously.

Methods: A retrospective review was performed to compare the use of 1 versus 2 C-arms in the surgical stabilization of SCFE. Data analysis, including demographics, surgical setup times, operative times, and precision of screw placement was performed in 77 consecutive hips (69 patients).

Results: No significant differences were found between the single and dual C-arm techniques with respect to operating room setup and surgery times. Center-center positioning of the screw was more precise when using the simultaneous dual C-arm technique. Surgical times were longer in obese children, irrespective of the number of C-arms used.

Conclusions: Efficient operating room setup time for the dual C-arm technique is possible. Precision of screw placement is improved when using simultaneous biplanar fluoroscopy for the in situ pinning of SCFE.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Body Mass Index
  • Bone Screws*
  • Child
  • Epiphyses, Slipped / diagnostic imaging*
  • Epiphyses, Slipped / surgery
  • Femur Head / diagnostic imaging*
  • Femur Head / surgery
  • Fluoroscopy / methods*
  • Follow-Up Studies
  • Hip Joint
  • Humans
  • Obesity / complications
  • Orthopedic Procedures / instrumentation*
  • Reproducibility of Results
  • Retrospective Studies
  • Treatment Outcome