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Fixation for Slipped Capital Femoral Epiphysis On a Radiolucent Table

Sunday, October 21, 2012: 9:03 AM
Melrose (Hilton Riverside)
Matthew Butterfield1, Jose A. Herrera-Soto2 and Patrick B. Wright, MD2, (1)Orthopedics, Arnold Palmer Hospital for Children, Orlando, FL, (2)Pediatric Orthopaedics, Orlando Health, Orlando, FL

Purpose

There are two methods to position patients with SCFE in the operating room.  The most commonly used means today is on a fracture table.  The other method utilizes the radiolucent table. The purpose of this study was to determine if the described technique is time efficient, especially in those patients that require bilateral fixation during the same procedure.  For this purpose, we will compare the timing of this technique against the fracture table.  Last, we will compare radiation exposure time between the two types of tables used. 

Methods

We retrospectively reviewed the patients who underwent screw fixation for SCFE at our institution.    A chart review evaluated the age at the time of surgery, sex, weight and if possible, we calculated the body mass index.  Radiographically, we measured the preoperative Southwick angles and also determined stability.  We also compared the positioning timing as well as the preparation, surgical and radiation times were calculated for this surgeon with both positioning methods.  Patients who underwent synchronous bilateral fixation were also included in this data and their anesthesia time, surgical time and radiation exposure times will be evaluated.

Results

We had a total of 65 patients with 84 hips involved.  There were 14 hips with unstable slips.  We performed bilateral fixation in the same day on 16 patients (9 bilateral SCFE and 7 prophylactically).  The average BMI was similar in both groups (28.3 and 29.5) as well as slip severity. 

For the radiolucent table per hip (44), the procedure lasted in average 26 minutes more with an average of 66 seconds of radiation time and mean total OR time of 80 minutes.  For the fracture table per hip (40), the procedure lasted in average 36minutes more with an average of 180 seconds of radiation time and mean total OR time of 89 minutes.  There were no intraoperative complications.  Comparing bilateral cases, the radiolucent had 55 sec. of fluoro vs. 163; OR time was 95 min vs. 154 and total surgical time was 22 min vs. 45 minutes.

Conclusions

The use of a radiolucent table is a safe, and efficacious method of fixation of SCFE regardless of the BMI, slip severity or acuity.  It decreases the total anesthesia, and preparation time.  It demonstrated a shorter surgical time and radiation exposure, especially in bilateral cases.