Biomechanical considerations in slipped capital femoral epiphysis and insights into prophylactic fixation

Journal of Children's Orthopaedics
E LeblancO Birke

Abstract

Slipped capital femoral epiphysis (SCFE) is a deformity of the proximal femur secondary to widened and unstable physis. In stabilising the slip, gold standard treatments stop growth and involve premature physeal closure, which prevents the remodelling of the acquired deformity and creates a leg length discrepancy that may be significant in younger patients. We measured the impact of placing threaded screws across the proximal femoral physis by measuring the centre-trochanteric distance (CTD) and articulo-trochanteric distance (ATD) in participants with or without prophylactic fixation. We then compared the mechanical performance of static (stainless and titanium cannulated Synthes screws) and potentially growing implants (Synthes SCFE screw and Pega Medical Free Gliding screw) in a validated synthetic bone model. In the review of 30 non-fixed and 60 fixated hips over a mean follow-up of 1.9 years, we have noted a significant difference in pre/post CTD and ATD, as well as the change in CTD and ATD over time. In the biomechanical study, the newer implants allowing growth (Synthes SCFE screw and Pega Medical Free Gliding screw) were both shown to be at least non-inferior. The primary deformity of a SCFE in itself alters hip mechan...Continue Reading

References

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Jul 21, 2016·Journal of Children's Orthopaedics·Jolanda J de PoorterMichiel A J van der Sande

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Citations

May 23, 2017·Journal of Children's Orthopaedics·R Krauspe, S Weinstein
Mar 26, 2019·Journal of Orthopaedic Research : Official Publication of the Orthopaedic Research Society·Ata M KiapourEduardo N Novais
Jun 8, 2018·Journal of Pediatric Orthopedics·Jonathan Wright, Manoj Ramachandran
Nov 1, 2017·Journal of Orthopaedic Surgery and Research·Francesco FalcigliaVincenzo Guzzanti
Feb 10, 2021·Journal of Pediatric Orthopedics·Kevin MorashKarl Logan
Jul 10, 2021·The Anatomical Record : Advances in Integrative Anatomy and Evolutionary Biology·Ronald Vincent Perrone, John Leicester Williams

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