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Journal of Pediatric Orthopaedics:
January/February 2008 - Volume 28 - Issue 1 - pp 43-48
doi: 10.1097/BPO.0b013e3181558bee
Hip/Femur: Original Article

Simultaneous Biplanar Fluoroscopy for the Surgical Treatment of Slipped Capital Femoral Epiphysis

Westberry, David E. MD; Davids, Jon R. MD; Cross, Andrew MD; Tanner, Stephanie L. MS; Blackhurst, Dawn W. DrPh

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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.

Level of Evidence: Level IV.

© 2008 Lippincott Williams & Wilkins, Inc.

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