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General Orthopaedics

A RETROSPECTIVE RADIOLOGICAL REVIEW OF THE MANAGEMENT OF SLIPPED CAPITAL FEMORAL EPIPHYSIS, EVALUATING THE USE OF A SINGLE CANNULATED SCREW, FROG LATERAL POSITIONING FOR IMAGING AND THE RISK OF SLIP PROGRESSION

The South African Orthopaedic Association (SAOA) 60th Annual Congress



Abstract

Purpose of Study:

In situ fixation with cannulated screws, is the most common surgical management of Slipped Capital Femoral Epiphysis. Surgeons are wary of the consequences to the epiphysis with any manipulation of the hip. The purpose of this study, was to evaluate the use of a single cannulated screw, inserted with imaging done in the standard AP position, and gentle positioning for a frog lateral X-ray, and the risk of slip progression.

Description:

A retrospective radiological review was done on 18 patients between the ages of 9–14 treated for unstable slips from 2006–2014. All patients were treated with a single partially threaded, cannulated screw inserted from the anterior aspect of the neck perpendicular to the epiphysis. Intraoperative imaging included an AP image, and thereafter the hip was gently abducted and externally rotated for a frog lateral view.

Radiological comparison of the preoperative, postoperative and subsequent follow up X-rays was done.

Follow up ranged from 6 months to 8 years.

Results:

Radiographs showed no significant slip progression post op.

Conclusion:

Gentle positioning for a frog lateral image during screw placement, and a single screw technique appears to be a safe in the management of unstable slips in Slipped Capital Femoral Epiphysis.