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| Name | Percutaneous in Situ Fixation of Slipped Capital Femoral Epiphysis |
| Video Uploader | Video From JBJSmedia |
| Upload Date | This Video Uploaded At 28-04-2017 19:06:43 |
| Video Discription | Full video: http://surgicaltechniques.jbjs.org/content/6/1/e11 Slipped capital femoral epiphysis (SCFE), a common cause of adolescent hip pain, is a displacement of the femoral head through the proximal femoral physis. The exact etiology of SCFE is unknown, but both biochemical and biomechanical factors, including obesity, femoral retroversion, increased physeal obliquity, puberty, and endocrinopathies, play a role. Patients often present with hip, groin, or knee pain and an antalgic gait. On physical examination, obligate external rotation of the lower limb with passive hip flexion is a hallmark of SCFE. The diagnosis is confirmed with radiographs, with advanced imaging reserved for atypical presentations. Any degree of SCFE is an indication for internal stabilization. Percutaneous in situ fixation remains the gold-standard treatment for slipped capital femoral epiphysis. The procedure is performed with the following steps: (1) the patient is positioned supine on a fracture table with the contralateral lower limb in the hemilithotomy position; (2) a 1-cm longitudinal incision is made over the anterolateral aspect of the proximal part of the femur; (3) under fluoroscopic guidance, a guidewire is advanced freehand into the “center-center” of the epiphysis, stopping approximately 3 mm short of the articular surface; (4) the guidewire is overdrilled, and a 6.5-mm partially threaded cannulated screw of appropriate length is inserted into the epiphysis; (5) the proximal part of the femur is brought through a full range of internal-external rotation under fluoroscopy to confirm that the screw has not violated the joint cavity; and (6) the wound is closed in layers and a sterile dressing is applied. |
| Category | Education |
| Tags | femoral | epiphysis | hip | pain | surgery | bone | joint | orthopedic | orthopaedic | SCFE |
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