To Pin a SCFE One Screw is Preferred than Two Screws in Children

Abstract

Background: Slipped capital femoral epiphysis (SCFE) is one of the most frequent hip disorders in children. SCFE is due to the displacement of the epiphysis (femoral head that keeps its location in the acetabulum) relative to the metaphysis (femoral neck) and shaft at the physic level. Treatment seeks to prevent worsening of epiphyseal slippage on the metaphysis, and percutaneous in situ fixation (ISF) using a single cannulated screw has long shown efficacy. Case Presentation: An 11 years old boy presented with diagnosed with slipped capital femoral epiphysiolysis of right hip and treated operatively with one screw pinning guiding fluoroscopy. Post operatively, from X-Ray evaluation confirmed the proper position without joint penetration. Patient is then advised to walk with crutches for gradual weight bearing to full weight bearing after 4 weeks. Then after 6 weeks, patient had already walked normally again. Conclusion:In unstable moderate-to-severe SCFE, the best reduction indications and technique remain controversial. There are many theories supporting one or two screws pinning technique. In this case we used one screw pinning fixation with excellent result.

Efficacy of Single Screw Fixation for Slipped Capital Femoral Epiphysis

“…As a result of their simplicity and less invasive nature, these procedures are in high demand (21) . The best location for the single screw is in the middle of the neck, perpendicular to the growth plate (22) . Chondrolysis, SCFE-induced impingement with accompanying damage to articular cartilage and labral injury, fixation failure and advancement of deformity, growth arrest and development of bilateral disease are among the more commonly described consequences (23) .…”