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Similar femoral growth and deformity with one screw versus two smooth pins for slipped capital femoral epiphysis

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Abstract

Purpose

To compare longitudinal growth and cam deformity of the proximal femur after treatment for slipped capital femoral epiphysis (SCFE) with one screw versus two smooth pins.

Methods

We studied 43 patients (29 males, 14 females; mean age, 12.1 years; range, 9.5–14 years) with idiopathic unilateral SCFE treated with in situ fixation with one cannulated screw (group A, n = 23) or two smooth pins (group B, n = 20). Anteroposterior and frog-leg radiographs of the pelvis were evaluated for each patient at initial presentation, post-operatively and at physeal closure. Longitudinal growth was evaluated using the femoral neck length (FNL), the caput–collum–diaphyseal (CCD) angle, and the articulo-trochanteric distance (ATD). Cam deformity was assessed using the anterior offset α-angle and the head–neck offset ratio (HNOR). The mean follow-up was 5.1 years (range, 4–7 years).

Results

Postoperatively, the mean CCD angle was 138.3°, the mean α-angle was 66.1° and the mean HNOR was − 0.030. At physeal closure, mean CCD angle significantly decreased to 133.6°, mean α-angle significantly reduced to 52.1°, and mean HNOR significantly improved to + 0.039. CCD, FNL, ATD, α-angle, and HNOR were not different between groups.

Conclusions

One screw or two smooth pins result in similar longitudinal growth and deformity of the proximal femur after SCFE. The femoral head–neck junction remarkably improves until physeal closure; however, residual cam deformity is not avoided after in situ pinning. The complication rate with smooth pins is higher.

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Authors and Affiliations

  1. First Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, 41 Ventouri Str., 15562, Athens, Greece

    Panayiotis D. Megaloikonomos, Andreas F. Mavrogenis, Georgios N. Panagopoulos & Vasilios G. Igoumenou

  2. Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece

    Giannis Giakas

  3. First Department of Orthopaedics, “P. and A. Kyriakou” Children’s Hospital, Athens, Greece

    Christos Zampakides

  4. Second Department Orthopaedics, “P. and A. Kyriakou” Children’s Hospital, Athens, Greece

    Dimitrios Pasparakis

Authors
  1. Panayiotis D. Megaloikonomos
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  2. Andreas F. Mavrogenis
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  3. Georgios N. Panagopoulos
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  4. Vasilios G. Igoumenou
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  5. Giannis Giakas
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Correspondence to Andreas F. Mavrogenis.

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Informed consent was obtained from all individual participants included in the study.

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Megaloikonomos, P.D., Mavrogenis, A.F., Panagopoulos, G.N. et al. Similar femoral growth and deformity with one screw versus two smooth pins for slipped capital femoral epiphysis. International Orthopaedics (SICOT) 43, 1627–1634 (2019). https://doi.org/10.1007/s00264-018-4058-9

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  • DOI: https://doi.org/10.1007/s00264-018-4058-9

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