Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis
Abstract Background In Sweden, most children with slipped capital femoral epiphysis (SCFE) are operated on with a single smooth pin or a short-threaded screw, allowing further growth of the femoral neck. Using the Swedish Pediatric Orthopaedic Quality registry, SPOQ, we investigated whether angular...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-01-01
|
| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-023-07117-y |
| _version_ | 1797363756519391232 |
|---|---|
| author | Mattias Anderson Bengt Herngren Hans Tropp Olof Risto |
| author_facet | Mattias Anderson Bengt Herngren Hans Tropp Olof Risto |
| author_sort | Mattias Anderson |
| collection | DOAJ |
| description | Abstract Background In Sweden, most children with slipped capital femoral epiphysis (SCFE) are operated on with a single smooth pin or a short-threaded screw, allowing further growth of the femoral neck. Using the Swedish Pediatric Orthopaedic Quality registry, SPOQ, we investigated whether angular remodelling occurs adjacent to the proximal femoral epiphysis after fixation of SCFE using implants, allowing continued growth of the femoral neck. Methods During 2008–2010 a total national population of 155 children were reported to the SPOQ registry. Following our strict inclusion criteria, radiographs of 51 hips were further assessed. The lateral Head Shaft Angle (HSA), the Nötzli 3-point α-angle, the anatomic α-angle, and the Anterior Offset Ratio (AOR) on the first postoperative radiographs and at follow-up were measured to describe the occurrence of remodelling. Slip severity was categorised as mild, moderate or severe according to postoperative HSA. Results Mean and SD values for the change in HSA were 3,7° (5,0°), for 3-point α-angle 6,8° (8,9°), and anatomic α-angle 13,0° (16,3°). The overall increase in AOR was 0,038 (0.069). There were no significant differences between the slip severity groups. Conclusions We found limited angular remodelling after in situ fixation with smooth pins or short threaded screws for SCFE. The angular remodelling and the reduction of the CAM deformity was less than previously described after fixation of SCFE with similar implants. Results about the same magnitude with non-growth sparing techniques suggest that factors other than longitudinal growth of the femoral neck are important for angular remodelling. |
| first_indexed | 2024-03-08T16:25:38Z |
| format | Article |
| id | doaj.art-b836d2a1eebe48e08f172f9d574a4831 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-03-08T16:25:38Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-b836d2a1eebe48e08f172f9d574a48312024-01-07T12:04:13ZengBMCBMC Musculoskeletal Disorders1471-24742024-01-012511910.1186/s12891-023-07117-yLimited angular remodelling after in-situ fixation for slipped capital femoral epiphysisMattias Anderson0Bengt Herngren1Hans Tropp2Olof Risto3Department of Orthopaedics, University HospitalDepartment of Biomedical and Clinical Sciences, Linköping UniversityDepartment of Biomedical and Clinical Sciences, Linköping UniversityDepartment of Biomedical and Clinical Sciences, Linköping UniversityAbstract Background In Sweden, most children with slipped capital femoral epiphysis (SCFE) are operated on with a single smooth pin or a short-threaded screw, allowing further growth of the femoral neck. Using the Swedish Pediatric Orthopaedic Quality registry, SPOQ, we investigated whether angular remodelling occurs adjacent to the proximal femoral epiphysis after fixation of SCFE using implants, allowing continued growth of the femoral neck. Methods During 2008–2010 a total national population of 155 children were reported to the SPOQ registry. Following our strict inclusion criteria, radiographs of 51 hips were further assessed. The lateral Head Shaft Angle (HSA), the Nötzli 3-point α-angle, the anatomic α-angle, and the Anterior Offset Ratio (AOR) on the first postoperative radiographs and at follow-up were measured to describe the occurrence of remodelling. Slip severity was categorised as mild, moderate or severe according to postoperative HSA. Results Mean and SD values for the change in HSA were 3,7° (5,0°), for 3-point α-angle 6,8° (8,9°), and anatomic α-angle 13,0° (16,3°). The overall increase in AOR was 0,038 (0.069). There were no significant differences between the slip severity groups. Conclusions We found limited angular remodelling after in situ fixation with smooth pins or short threaded screws for SCFE. The angular remodelling and the reduction of the CAM deformity was less than previously described after fixation of SCFE with similar implants. Results about the same magnitude with non-growth sparing techniques suggest that factors other than longitudinal growth of the femoral neck are important for angular remodelling.https://doi.org/10.1186/s12891-023-07117-ySlipped capital femoral epiphysisSCFERemodelling |
| spellingShingle | Mattias Anderson Bengt Herngren Hans Tropp Olof Risto Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis BMC Musculoskeletal Disorders Slipped capital femoral epiphysis SCFE Remodelling |
| title | Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis |
| title_full | Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis |
| title_fullStr | Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis |
| title_full_unstemmed | Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis |
| title_short | Limited angular remodelling after in-situ fixation for slipped capital femoral epiphysis |
| title_sort | limited angular remodelling after in situ fixation for slipped capital femoral epiphysis |
| topic | Slipped capital femoral epiphysis SCFE Remodelling |
| url | https://doi.org/10.1186/s12891-023-07117-y |
| work_keys_str_mv | AT mattiasanderson limitedangularremodellingafterinsitufixationforslippedcapitalfemoralepiphysis AT bengtherngren limitedangularremodellingafterinsitufixationforslippedcapitalfemoralepiphysis AT hanstropp limitedangularremodellingafterinsitufixationforslippedcapitalfemoralepiphysis AT olofristo limitedangularremodellingafterinsitufixationforslippedcapitalfemoralepiphysis |